Prevalence and Associated Factors of Mild Cognitive Impairment in Parkinson’s Disease: A Single-Center Study in Thailand
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Abstract
Objectives: Mild cognitive impairment ( MCI) is a frequent non-motor complication and a strong predictor of dementia in patients with Parkinson’s disease ( PD). Reported prevalence rates vary considerably due to differences in diagnostic criteria and study populations, with limited data available from Thai cohorts. This study aimed to determine the prevalence of PD-MCI and identify associated factors among Thai patients with PD.
Materials and Methods: A cross-sectional study was conducted involving 100 patients with mild to moderate PD who attended the Movement Disorders Clinic at Vajira Hospital, Bangkok, between February and October 2023. Patients with disabilities, dementia, or major neurological comorbidities were excluded. Cognitive function was assessed using the Thai version of the Montreal Cognitive Assessment in patients with PD who reported cognitive concerns, as reported by patients, caregivers, or both, applying a cutoff score of < 25 points and adding one point for participants with ≤ 6 years of education. Demographic, clinical, and comorbidity data were collected. Independent predictors of PD-MCI were analyzed using univariate and multivariate logistic regression models.
Results: Among 100 patients with PD, 54% were female. Nearly one-third of participants (31%) had completed education beyond grade 12, and the median disease duration was 3 years. The prevalence of PD-MCI was 81%. Patients with PD-MCI were significantly older (74.3 ± 8.3 vs. 66.5 ± 8.7 years, p < 0.001), had lower educational attainment (45.7% vs. 10.5% below grade 6, p = 0.005), and lower body mass index (BMI) (23.2 ± 4.1 vs. 25.5 ± 4.2 kg/m², p = 0.035). Hypertension, hyperlipidemia, later age at onset, and mixed phenotype were also associated in univariate analyses. In multivariate regression, age ≥ 70 years (adjusted odds ratio (OR), 6.77; 95% confidence interval (CI), 1.35-34.08), education below grade 6 (adjusted OR, 10.35; 95% CI, 1.68-63.88), and obesity (BMI ≥ 25 kg/m²; adjusted OR, 0.07; 95% CI, 0.01-0.55) remained independent predictors.
Conclusion: PD-MCI is highly prevalent among Thai patients with PD. Older age, low education level, and lower BMI independently increased risk, whereas obesity appeared protective. Routine cognitive screening and targeted interventions are essential for this population. Further longitudinal studies are warranted to explore causal mechanisms.
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