Addressing the Cognitive Care Gap in Parkinson's Disease through Participatory Co-design of a Digital Neuropsychological Assessment Platform

Abstract Cognitive impairment is a prevalent and clinically significant feature of Parkinson’s disease (PD), although systematic neuropsychological assessment remains inconsistently integrated into movement disorder clinical care. Time constraints, limited neuropsychology workforce capacity, and fragmented data infrastructure impede early identification and longitudinal monitoring of cognitive decline in this population. The ‘PDCogniCare’ program aimed to address this gap by developing best-practice guidelines and a PD-specific neuropsychological toolkit. To implement this program in clinical settings, the PDCogniCare digital platform was co-designed and developed as a web-based tool to improve access to cognitive assessment, support clinician training, competence and confidence, and enable longitudinal tracking of neuropsychological outcomes across Movement disorders and psychology services. A participatory asynchronous co-design methodology was employed across three workshops and an interim system evaluation, across metropolitan health services in Queensland, Australia. Fifteen participants were involved, encompassing all interest holders in the neuropsychological assessment journey. Design activities included journey map refinement, MoSCoW feature prioritisation, low-fidelity prototype development, and iterative platform evaluation. Consumer and caregiver input was integrated throughout. The finalised platform received a mean System Usability Scale score of 82.5, placing it in the excellent range. Participants confirmed broad alignment between the platform and their clinical and lived experience priorities. Remaining concerns, including system integration, client enrolment, clinical pathway gaps, and data governance issues, were identified as priorities for future refinement prior to wider implementation. The findings support participatory co-design as an effective methodology for developing acceptable and clinically grounded digital health tools in neurodegenerative disease contexts.