The tools of the trade: A state of the art “How to Assess Cognition” in the patient with Parkinson's disease


  • Connie Marras MD, PhD,

    Corresponding author
    1. Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Research, Toronto Western Hospital, University of Toronto
    • Correspondence to: Connie Marras, MD, PhD, Movement Disorders Centre, Toronto Western Hospital 7McL, 399 Bathurst St., Toronto, ON M5T 2S8. E-mail:

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  • Alexander I. Tröster PhD,

    1. Barrow Neurological Institute, Phoenix, AZ
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  • Jaime Kulisevsky MD,

    1. Movement Disorders Unit, Neurology Department, Sant Pau Hospital (IIB Sant-Pau), Autonomous University of Barcelona and Networking Research Center on Neurodegenerative Diseases (CIBERNED), Spain
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  • Glenn T. Stebbins PhD

    1. Department of Neurological Sciences, Rush University Medical Center Chicago, IL
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  • Funding agencies: Dr. Marras is supported by a new investigator award from the Canadian Institutes of Health Research.

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.


Cognitive impairment in Parkinson's disease is heterogeneous both in severity and pattern and subject to influences both integral to and external to the disease. Diagnostic Criteria have been developed by the Movement Disorders Society that help to guide clinicians and researchers to an accurate diagnosis of Parkinson's disease — mild cognitive impairment or Parkinson's disease dementia. To operationalize these criteria, and to assess the pattern and severity of cognitive dysfunction we need: (1) Valid measures of cognitive abilities covering the major domains of cognition, (2) amethod to determine whether or not the performance represents a decline from a person's previous level of functioning, and (3) an assessment of how the individual's cognitive abilities enable (or disable) function in day to day activities. This paper will discuss the methods of assessment and the measures that can be used to make a comprehensive assessment of cognition in Parkinson's disease. © 2014 International Parkinson and Movement Disorder Society