Which Test Is the Best to Assess Visuo-Cognitive Impairment in Patients with Parkinson's Disease with Mild Cognitive Impairment and Dementia? A Systematic Review and Meta-Analysis

Hannah Liebermann-Jordanidis; Mandy Roheger; Lukas Boosfeld; Jeremy Franklin; Elke Kalbe

doi:10.3233/JPD-223238

Which Test Is the Best to Assess Visuo-Cognitive Impairment in Patients with Parkinson's Disease with Mild Cognitive Impairment and Dementia? A Systematic Review and Meta-Analysis

J Parkinsons Dis. 2022;12(6):1749-1782. doi: 10.3233/JPD-223238.

Authors

Hannah Liebermann-Jordanidis¹, Mandy Roheger^{1

2}, Lukas Boosfeld¹, Jeremy Franklin³, Elke Kalbe¹

Affiliations

¹ Department of Medical Psychology | Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
² Department of Neurology, University Medicine Greifswald, Greifswald, Germany.
³ Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, Cologne, Germany.

PMID: 35599499
DOI: 10.3233/JPD-223238

Abstract

Background: Visuo-cognitive impairment is common in patients with Parkinson's disease with mild cognitive impairment (PD-MCI) and constitutes a prognostic factor for the conversion to Parkinson's disease dementia (PDD). However, systematic analyses on which neuropsychological tests are most suitable to assess visuo-cognition in PD-MCI and PDD and to differentiate these cognitive stages are lacking.

Objective: To review neuropsychological tests used to assess visuo-cognition including visuo-perceptual and visuo-spatial processing, visuo-constructive copying and drawing on command abilities; and to identify the visuo-cognitive subdomain as well as tests most suitable to discriminate between PD-MCI and PDD.

Methods: MEDLINE, PsycINFO, Web of Science Core Collection, and CENTRAL were systematically searched for relevant studies assessing visuo-cognitive outcomes in patients with PD-MCI and PDD. Risk of bias was assessed using a customized form based on well-established tools. Random-effect meta-analyses were conducted.

Results: 33 studies were included in the systematic review. Data of 19 studies were entered in meta-analyses. Considerable heterogeneity regarding applied tests, test versions, and scoring systems exists. Data indicate that visuo-constructive command tasks are the subdomain best suited to discriminate between PD-MCI and PDD. Furthermore, they indicate that the Rey-Osterrieth-Complex-Figure Test (ROCF), Corsi Block-Tapping Test, Judgment of Line Orientation (JLO), and Clock Drawing Test (CDT) are tests able to differentiate between the two stages.

Conclusion: We provide suggestions for suitable visuo-cognitive tests (Corsi Block-Tapping Test, or JLO, ROCF, CDT) to improve diagnostic accuracy. Methodological challenges (e.g., heterogeneity of definitions, tests) are discussed and suggestions for future research are provided.

Registration: https://www.crd.york.ac.uk/prospero/, ID: CRD42018088244.

Keywords: Parkinson’s disease; cognition; cognitive aging; neuropsychological tests; spatial learning; spatial processing.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Alzheimer Disease*
Cognition
Cognitive Dysfunction* / diagnosis
Cognitive Dysfunction* / etiology
Cognitive Dysfunction* / psychology
Dementia* / complications
Dementia* / diagnosis
Humans
Neuropsychological Tests
Parkinson Disease* / complications
Parkinson Disease* / diagnosis
Parkinson Disease* / psychology