Objective:

To explore the relationship of the global cognitive summary score across multiple cognitive domains (CD) in PwPD and identify the relationship with confidence in medication management.

Background:

Parkinson’s Disease (PD) is a progressive disorder characterized by motor impairments. Cognitive impairment (CI) in people with PD (PwPD) causes “invisible” disability, which can develop independently. Medical regimens to treat motor symptoms in PwPD can involve multiple medications and varying frequencies, which may be hindered by cognitive impairment. Recognition of invisible cognitive impairments of varying types and degrees are not easily assessed by neurological examination. Computerized cognitive testing (CCT) can enhance routine examination by assessing cognitive changes and identify PwPD at risk of medication mismanagement. NeuroTrax is a CCT that evaluates seven cognitive domains. The SEMMT-SF-4a PRO is a validated measure to self-assess confidence in managing medications. The relationship between CI and mismanagement of medications in PwPD is not well understood.

Design/Methods:

177 PD patients (average age 70.2 ± 8.3 years; 63.4% female) were evaluated using NeuroTrax for the CDs, along with the aggregate score, “global cognitive score” (GCS). Self-efficacy for managing medications was evaluated with the SEMMT-SF-4a. The data was analyzed with two-Sample Assuming unequal variance t-tests.

Results:

The t-tests (p<0.05) evaluating the GCS, memory, executive function, visual spatial, verbal function, attention, information processing speed, and motor skills tested with medication self-efficacy had p-values of 6.8E-160, 1.3E-127, 2.1E-159, 7.3E-137, 4.8E-126, 1.2E-118, and 7.2E-138 respectively. These p-values reveal statistical significance between the CDs and medication self-efficacy scores.

Conclusions:

There is a relationship between the CCT global cognitive summary score and self-efficacy for management of medications in PwPD. CI in PwPD can adversely impact SEMMT. Medication mismanagement can result in adverse outcomes. Improved clinician awareness of such invisible problems can help prevent adverse outcomes. Incorporating CCT into routine care can improve such awareness of CI.