Association between cognitive and autonomic dysfunctions in patients with de novo Parkinson’s disease

Cognitive decline is a common issue in Parkinson's disease (PD) and significantly affects patients' quality of life. This study explored the relationship between cognitive functions and dysautonomia in de novo PD. We reviewed records of newly diagnosed PD patients from July 2017 to September 2023 who underwent cognitive and autonomic assessments. Cognitive functions were measured using the Korean version of the Montreal Cognitive Assessment (MoCA-K) and the Seoul Neuropsychological Screening Battery, while autonomic functions were evaluated with the SCOPA-AUT questionnaire. Among 155 patients, 82 with de novo PD were included. The mild cognitive impairment (MCI) group exhibited higher SCOPA-AUT scores, particularly in gastrointestinal dysfunction. Multivariable logistic regression identified total SCOPA-AUT scores as significant predictors of MCI, even after adjusting for demographic and clinical factors. Partial correlation analysis showed significant negative associations between SCOPA-AUT scores and cognitive functions, such as memory and executive function. This study highlights a strong link between autonomic dysfunction, including gastrointestinal issues, and cognitive impairment in de novo PD. Monitoring dysautonomia in early-stage PD may aid in identifying patients at risk of cognitive decline.