Association Between Turn Impairments and Cognitive Function in Parkinson Disease

Abstract

Objective

To investigate the association of turn parameters with cognitive status in patients with Parkinson disease (PD) and determine the value of turn performance in distinguishing PD-related cognitive impairment (CI) from normal cognition (NC).

Methods

This study recruited 168 patients with PD, including 102 patients with NC and 66 patients with CI. The participants performed 180° turn performance trials during the Timed Up and Go walk and 360° turn trials in place using the MATRIX wearable system. Four turn parameters, namely, turn duration, step count, mean turn angular velocity (MAV), and peak turn angular velocity (PAV), were evaluated. Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were performed to evaluate cognitive function.

Results

In comparison with the PD-NC group, the PD-CI group showed significantly higher turn duration and step counts and lower MAV and PAV during both 180° and 360° turns. The four turn parameters were significantly correlated with MMSE and MoCA scores after correction for age and educational level. Regression models suggested that the risk of PD-CI was associated with step counts and MAV during 360° turns. The area under the curve values of the step counts and MAV during 360° turns for distinguishing PD-CI from PD-NC were 0.781 and 0.789, respectively.

Conclusion

Our findings indicate that turn performance is associated with cognitive status in patients with PD. Assessment of 360° turn characteristics during routine clinic visits would provide a better understanding of CI status in individuals with PD.