Accuracy of Two Cognitive Screening Tools to Detect Mild Cognitive Impairment in Parkinson's Disease

Background: Patients with Parkinson's disease (PD) who have mild cognitive impairment (PD-MCI) are at increased risk of developing PD dementia (PDD). Therefore, it is important to identify PD-MCI in a reliable way. Objectives: We evaluated the accuracy of the Parkinson's Disease-Cognitive Rating Scale (PD-CRS) and the Mattis Dementia Rating Scale-2 (MDRS-2) for detecting PD-MCI. Data from healthy subjects were used to correct for demographic influences. Methods: We compared the accuracy of the two instruments using ROC analysis. The gold standard was level II diagnosis of PD-MCI according to consensus criteria of the International Parkinson and Movement Disorder Society. Results: Seventy-five healthy subjects and 125 PD patients were included. Education level, age and sex correlated with the PD-CRS, but only age correlated with the MDRS-2. Twenty-seven percent of the patients had PD-MCI. Areas under the curve (AUCs) for raw scores of PD-CRS and MDRS-2 were 0.83 and 0.81, respectively. At the optimal cut-off for the PD-CRS (101/102), sensitivity was 88% and specificity was 64%. For the MDRS-2 (139/140) sensitivity and specificity were 68% and 79%, respectively. AUCs for demographically corrected scores of PD-CRS and for age-corrected scores of MDRS-2 were 0.80 and 0.78, respectively. At the optimal cut-off for the PD-CRS, sensitivity was 79% and specificity was 72%, while for the MDRS-2 these were 77% and 67%, respectively. Conclusions: Both cognitive screening tools are suitable for distinguishing PD-MCI patients from cognitively intact PD patients. Demographical correction of scores did not improve sensitivity and specificity

Effect of physical exercise on cognitive function and brain measures after chemotherapy in patients with breast cancer (PAM study): Protocol of a randomised controlled trial

Introduction After treatment with chemotherapy, many patients with breast cancer experience cognitive problems. While limited interventions are available to improve cognitive functioning, physical exercise showed positive effects in healthy older adults and people with mild cognitive impairment. The Physical Activity and Memory study aims to investigate the effect of physical exercise on cognitive functioning and brain measures in chemotherapy-exposed patients with breast cancer with cognitive problems. Methods and analytics One hundred and eighty patients with breast cancer with cognitive problems 2-4 years after diagnosis are randomised (1:1) into an exercise intervention or a control group. The 6-month exercise intervention consists of twice a week 1-hour aerobic and strength exercises supervised by a physiotherapist and twice a week 1-hour Nordic or power walking. The control group is asked to maintain their habitual activity pattern during 6 months. The primary outcome (verbal learning) is measured at baseline and 6 months. Further measurements include online neuropsychological tests, self-reported cognitive complaints, a 3-tesla brain MRI, patient-reported outcomes (quality of life, fatigue, depression, anxiety, work performance), blood sampling and physical fitness. The MRI scans and blood sampling will be used to gain insight into underlying mechanisms. At 18 months online neuropsychological tests, self-reported cognitive complaints and patient-reported outcomes will be repeated. Ethics and dissemination Study results may impact usual care if physical exercise improves cognitive functioning for breast cancer survivors. Trial registration number NTR610

Effect of physical exercise on cognitive function and brain measures after chemotherapy in patients with breast cancer (PAM study): Protocol of a randomised controlled trial

Introduction After treatment with chemotherapy, many patients with breast cancer experience cognitive problems. While limited interventions are available to improve cognitive functioning, physical exercise showed positive effects in healthy older adults and people with mild cognitive impairment. The Physical Activity and Memory study aims to investigate the effect of physical exercise on cognitive functioning and brain measures in chemotherapy-exposed patients with breast cancer with cognitive problems. Methods and analytics One hundred and eighty patients with breast cancer with cognitive problems 2-4 years after diagnosis are randomised (1:1) into an exercise intervention or a control group. The 6-month exercise intervention consists of twice a week 1-hour aerobic and strength exercises supervised by a physiotherapist and twice a week 1-hour Nordic or power walking. The control group is asked to maintain their habitual activity pattern during 6 months. The primary outcome (verbal learning) is measured at baseline and 6 months. Further measurements include online neuropsychological tests, self-reported cognitive complaints, a 3-tesla brain MRI, patient-reported outcomes (quality of life, fatigue, depression, anxiety, work performance), blood sampling and physical fitness. The MRI scans and blood sampling will be used to gain insight into underlying mechanisms. At 18 months online neuropsychological tests, self-reported cognitive complaints and patient-reported outcomes will be repeated. Ethics and dissemination Study results may impact usual care if physical exercise improves cognitive functioning for breast cancer survivors. Trial registration number NTR610