A brief neuropsychological protocol for assessing patients with Parkinson's disease

Mild to severe cognitive impairment and depression are common among patients with Parkinson's disease (PD) and play a significant role in disability. Effective treatment planning requires a holistic assessment of cognitive and emotional difficulties. A brief neuropsychological protocol was developed to examine the pattern of cognitive and emotional functioning of patients with idiopathic PD. Data was retrospectively analyzed for the first 61 male veterans who were evaluated at an interdisciplinary movement disorders clinic. The most frequently observed cognitive impairments were in the areas of auditory learning, delayed recall memory, and visual motor functioning that required alternating tracking and sequencing. Executive dysfunction was marked by the inability of 60% of the sample to complete the Wisconsin Card Sorting Test, a measure of non-verbal reasoning with a cognitive flexibility component. Clinical interviews revealed that 28% of the sample met DSM-IV Criterion A for a Major Depressive Episode. The findings suggested that this brief neuropsychological protocol established cognitive and emotional profiles of patients with PD, consistent with other samples of patients with Parkinson's Disease. Clinical uses of the brief neuropsychological protocol are detailed. Selection of an alternative executive function measure with a lower "floor" that minimizes patient fatigue and frustration is recommended.