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Background <p>Parkinson’s disease (PD) may present with early-onset (EOPD) or late-onset (LOPD). Lower cognitive performance has been reported more frequently in LOPD, although findings remain inconsistent, partly due to limited control of confounders such as age at assessment, education, and disease severity.</p> Aims <p>To evaluate associations of age at assessment, age at onset, education, clinical severity, and emotional factors with cognitive performance in PD, and to compare performance between EOPD, LOPD, and controls in Mexico.</p> Methods <p>We analyzed 249 patients with PD and 102 healthy controls from the Mex-PD cohort. Cognition was assessed using the Montreal Cognitive Assessment (MoCA). Multiple linear regression models identified variables associated with cognitive performance. Given collinearity among age-related variables, moderation analyses examined interactions between age at assessment, age at onset, group, and disease severity. Nearest-neighbor matching was used for group comparisons.</p> Results <p>Age at assessment was most strongly associated with lower cognitive performance, followed by education and disease severity. Age at onset was not independently associated with cognition. Cognitive differences between EOPD and LOPD disappeared after controlling for age at assessment. Disease severity was significantly associated with lower cognitive performance from 59 years onward. In matched samples, both PD groups showed lower global cognition than controls, with delayed recall most affected.</p> Conclusions <p>In this cross-sectional study, lower cognitive performance in PD was more strongly associated with age at assessment and its interaction with disease severity than with age at onset. Education and cognitive reserve were positively associated with cognitive performance, consistent with their protective role.</p>

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Does cognitive performance decline as a function of age at onset in Parkinson’s disease? the role of age at assessment, education, and clinical severity

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Andrés A. Morales-de-Arcia,
  • Alejandra Lázaro-Figueroa,
  • Ulises Caballero-Sánchez,
  • Gabriel De-Anda-Moctezuma,
  • Itzel Hernández-Ruiz,
  • Paula Reyes-Pérez,
  • Juan Manuel Esquivias-Farías,
  • Carlos M. Guerra-Galicia,
  • Eugenia Morelos-Figaredo,
  • Ingrid Estrada-Bellmann,
  • Roberto Trejo-Ayala,
  • Karla Salinas-Barboza,
  • Yamil Matuk,
  • Nadia A. Gandarilla-Martínez,
  • Dante Oropeza,
  • Araliz López-Pintor,
  • Miriam Nolasco-López,
  • Ana P. Angulo-Arrieta,
  • Alejandra Zayas-Del Moral,
  • Alejandra Medina-Rivera,
  • Sarael Alcauter,
  • Miguel Rentería,
  • Alejandra E. Ruiz-Contreras,
  • Anke Paula Ingrid Kleinert Altamirano,
  • Sara Isaís Millán,
  • Diana Carolyn Deras Gaucin,
  • Omar Cárdenas Sáenz,
  • Ildefonso Rodríguez Leyva,
  • Lucero de María Ugalde Mejía,
  • Maritza Jacqueline Valadez,
  • Moisés Rubio,
  • Carlos Martínez,
  • Teresa Pérez,
  • Damaris Daniela Vázquez Guevara

摘要

Background

Parkinson’s disease (PD) may present with early-onset (EOPD) or late-onset (LOPD). Lower cognitive performance has been reported more frequently in LOPD, although findings remain inconsistent, partly due to limited control of confounders such as age at assessment, education, and disease severity.

Aims

To evaluate associations of age at assessment, age at onset, education, clinical severity, and emotional factors with cognitive performance in PD, and to compare performance between EOPD, LOPD, and controls in Mexico.

Methods

We analyzed 249 patients with PD and 102 healthy controls from the Mex-PD cohort. Cognition was assessed using the Montreal Cognitive Assessment (MoCA). Multiple linear regression models identified variables associated with cognitive performance. Given collinearity among age-related variables, moderation analyses examined interactions between age at assessment, age at onset, group, and disease severity. Nearest-neighbor matching was used for group comparisons.

Results

Age at assessment was most strongly associated with lower cognitive performance, followed by education and disease severity. Age at onset was not independently associated with cognition. Cognitive differences between EOPD and LOPD disappeared after controlling for age at assessment. Disease severity was significantly associated with lower cognitive performance from 59 years onward. In matched samples, both PD groups showed lower global cognition than controls, with delayed recall most affected.

Conclusions

In this cross-sectional study, lower cognitive performance in PD was more strongly associated with age at assessment and its interaction with disease severity than with age at onset. Education and cognitive reserve were positively associated with cognitive performance, consistent with their protective role.