Assessment of cognitive function and associated factors among Parkinson’s disease patients and control group using IDEA cognitive screen, TASH, A.A, Ethiopia.
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Date
2024-02-14
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Addis Ababa University
Abstract
Background: The global prevalence of Parkinson’s disease (PD) is on the rise and is expected to
reach nearly 9 million cases by 2030. Cognitive impairment (CI), which encompasses both
dementia and cognitive impairment without dementia (CIND), represents a common
complications of PD that carry significant clinical consequences. About 40% of individuals with
PD develop dementia—this rate is six times greater than that of age-matched healthy peers. The
Identification of Dementia in Elderly Africans (IDEA) cognitive screen is a concise, multi
dimensional assessment tool created to tackle the educational bias seen in other cognitive
screening instruments used in sub-Saharan Africa. This research evaluates cognitive ability in
PD patients utilizing the validated IDEA cognitive screen. In our clinical environment, there is a
need for routine cognitive impairment screening among PD patients. This need arises from the
lengthy and education-biased nature of currently available validated cognitive assessment tools.
Conversely, the IDEA screen is a brief cognitive assessment that is practical for implementation
in busy tertiary hospitals such as TASH.
Objective: To assess cognitive function and associated factors among Parkinson’s disease
patients and baseline characteristics matched control group using IDEA cognitive screen, Tikur
Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Methods: A comparative cross-sectional study was conducted using systematic random
sampling on 150 PD patients and on 150 baseline-matched control group; age, sex, educational
level & comorbidity at TASH from September to December 2024. Data were collected using
pretested questionnaires and the IDEA cognitive tool by trained neurology residents & general
practitioners. The data was cleaned, edited, entered, and analyzed using SPSS version 30. A non
parametric regression model was employed to determine factors associated with cognitive
function impairment.
Results: Among 150 PD patients, 3.3% met the criteria for probable dementia and 9.3% for
possible dementia based on IDEA screening. The prevalence of cognitive impairment in the PD
group was 9.9% higher than in the matched control group. The median IDEA score was
significantly lower in PD patients (12.4 ± 2.25) compared to controls (13.31 ± 1.53). Among PD
patients, median IDEA scores declined progressively with older age and lower educational
attainment. Illiteracy emerged as the sole significant predictor of cognitive impairment in
multivariate analysis.
Conclusion: In this study, IDEA revealed probable or possible dementia in 12.6% of PD patients
versus 2.7% of controls, reflecting a fourfold higher prevalence of cognitive impairment in PD.
Illiteracy was the sole significant predictor of dementia in PD patients, highlighting residual
educational bias despite IDEA’s design for low-literacy settings. Key suggestions from the study
iv
include developing education-stratified IDEA cutoffs for urban LMIC populations, validating
IDEA against PD-specific diagnostic tools, improving healthcare-seeking behavior among PD
patients, and supplementing IDEA with PD-focused cognitive screens to better capture PD
associated mild cognitive impairment. Further research, such as multicenter stu
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Keywords
Assessment of cognitive, associated factors among Parkinson’s, disease patients and control