Pourzinal Dana, Elgey Charlotte, Bailey Daniel X, Yang Jihyun, Lehn Alexander, Tinson Helen, Liddle Jacki, Brooks Deborah, Naismith Sharon L, Shrubsole Kirstine, Marsh Rodney, Mitchell Leander K, Pachana Nancy A, King James, Dissanayaka Nadeeka N
The University of Queensland Centre for Clinical Research, Herston, Australia.
The University of Queensland Centre for Health Service Research, Herston, Australia.
Int Psychogeriatr. 2025 May 12:100081. doi: 10.1016/j.inpsyc.2025.100081.
There is considerable variability in the diagnosis, evaluation and management of cognitive disorders in Parkinson's disease (PD) across clinical services. A review of guidelines and relevant literature will provide recommendations to guide clinical decision-making. The present review aimed to summarise and critically appraise current recommendations for the diagnosis, evaluation and management of cognitive disorders in PD.
Five academic databases (PubMed, SCOPUS, Medline, PsycINFO, CINAHL) and five grey literature databases were systematically searched in August 2024 by two independent reviewers following PRISMA guidelines. Guidelines and systematic reviews from 2003-2024 available in English and reporting at least one relevant recommendation for the diagnosis, evaluation or management of cognitive disorders in PD were included. Quality assessment was completed using the AGREE-II tool for guidelines and AMSTAR tool for systematic reviews.
In total, 32 guidelines and 24 systematic reviews were included. Guideline quality ranged from moderate to high and systematic review quality from critically low to high. Articles provided recommendations for cognitive impairment in PD in terms of diagnosis, neuropsychological evaluation, treatment and care. However, recommendations for cognitive tools, care considerations, and non-pharmacological interventions were limited, despite relevant evidence from the systematic review literature.
Significant gaps identified in processes for neuropsychological evaluations, inconsistent recommendations for non-pharmacological interventions, and limited care considerations calls for future iterations of the clinical practice guidelines for cognitive impairment in PD.
帕金森病（PD）认知障碍的诊断、评估和管理在不同临床服务中存在很大差异。对指南和相关文献进行综述将提供指导临床决策的建议。本综述旨在总结和批判性评价目前关于PD认知障碍诊断、评估和管理的建议。
2024年8月，两名独立评审员按照PRISMA指南对五个学术数据库（PubMed、SCOPUS、Medline、PsycINFO、CINAHL）和五个灰色文献数据库进行了系统检索。纳入2003年至2024年可用的英文指南和系统评价，且至少报告一项关于PD认知障碍诊断、评估或管理的相关建议。使用AGREE-II工具对指南进行质量评估，使用AMSTAR工具对系统评价进行质量评估。
共纳入32项指南和24项系统评价。指南质量从中等到高，系统评价质量从极低到高。文章在PD认知障碍的诊断、神经心理学评估、治疗和护理方面提供了建议。然而，尽管系统评价文献有相关证据，但关于认知工具、护理考虑因素和非药物干预的建议有限。
神经心理学评估过程中存在重大差距、非药物干预建议不一致以及护理考虑因素有限，这就需要对PD认知障碍临床实践指南进行未来的迭代更新。
