Attention/Working Memory and Executive Function in Parkinson's Disease: Review, Critique, and Recommendations

Roberta Biundo, Department of General Psychology, University of Padua, Padua, Italy.
Ondrej Bezdicek, Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic.
Davide Maria Cammisuli, Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy.
Brenna Cholerton, Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.
John C. Dalrymple-Alford, Te Kura Mahi ā-Hirikapo School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.
Nicola Edelstyn, Department of Psychology, Bath Spa University, Bath, UK.
Eleonora Fiorenzato, Neurodegenerative Disease Unit, Department of Neuroscience, University of Padua, Padua, Italy.
Erin Holker, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Saul Martinez-Horta, Movement Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Research Institute Sant Pau, Barcelona, Spain.
Alice Martini, Addiction and Mental Health Department, Azienda Sanitaria Friuli Occidentale, Pordenone, Italy.
Gabriella Santangelo, Department of Psychology, University of Campania, "Luigi Vanvitelli", Caserta, Italy.
Barbara Segura, Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.
Chiara Siri, Parkinson's Disease and Movement Disorders Neurorehabilitation Unit, Moriggia Pelascini Hospital, Como, Italy.
Alexander Tröster, Department of Clinical Neuropsychology and Center for Neuromodulation, Barrow Neurological Institute, Phoenix, Arizona, USA.
Tiago A. Mestre, Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Institute, Ottawa, Ontario, Canada.
Álvaro Sánchez Ferro, Centro de Investigagión Biomédica en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
Michelle Hyczy de Siqueira Tosin, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.
Matej Skorvanek, Department of Neurology, Safarik University, Kosice, Slovakia.
Daniel Weintraub, Department of Psychiatry, University of Pennsylvania School of Medicine; Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
Gert J. Geurtsen, Department of Medical Psychology, Amsterdam UMC Location, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.

Document Type

Article

Abstract

BACKGROUND: Cognitive impairment in Parkinson's disease (PD) is a well-established non-motor complication that significantly affects the quality of life and well-being of both patients and care partners. To optimally detect mild cognitive impairment or dementia, extensive neuropsychological assessment is essential. A wide range of cognitive tests and clinical outcome assessments have been used in clinical settings, often without regard to their clinimetric quality. METHODS: We performed a literature review of tests assessing attention/working memory and executive domains in PD (tests on other domains are included in an accompanying review). The selected tests were evaluated for their clinimetric properties and categorized by a panel of experts as "recommended," "recommended with caveats," "suggested," or "listed" according to the International Parkinson and Movement Disorder Society Clinical Outcome Assessment Scientific Evaluation Committee guidelines. RESULTS: A total of 30 tests were reviewed. Eight tests were "recommended," including four tests assessing attention/working memory abilities (WAIS-IV Digit Span, Coding and Symbol Search subtests, and Trail Making Test) and four tests assessing executive abilities (WAIS-IV Similarities, Wisconsin Card Sorting Test, Fluency Tests, and Stroop Color-Word Test). These tests demonstrated good to excellent levels of reliability and validity, have normative datasets, and are sensitive to change. Eight other tests were "recommended with caveats", eleven were "suggested," and three were "listed." CONCLUSIONS: The recommended tests for attention/working memory and executive functioning in PD can guide PD cognitive assessment. Other tests were identified as potentially useful; however, caution is advised due to their clinimetric limitations. Further validation studies are required for these tests. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Medical Subject Headings

Humans; Parkinson Disease (complications, physiopathology); Executive Function (physiology); Memory, Short-Term (physiology); Neuropsychological Tests (standards); Attention (physiology); Cognitive Dysfunction (etiology, diagnosis, physiopathology)

Publication Date

9-1-2025

Publication Title

Movement disorders : official journal of the Movement Disorder Society

E-ISSN

1531-8257

Volume

40

Issue

9

First Page

1791

Last Page

1804

PubMed ID

40678921

Digital Object Identifier (DOI)

10.1002/mds.30293

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