NeuroDash

The case library

early — tier 2 — Parkinson’s disease

The pot on the stove — cognition enters the plan

Patient64F, early stage
ConditionIdiopathic Parkinson’s disease, H&Y II, with early cognitive change (suspected PD-MCI)
SeverityUPDRS-III 24
Days since diagnosis182
Before the diagnosisIndependent. Librarian three days a week; drove, cooked, ran the book club.
Also on the chartPoor sleep since the diagnosis
PrecautionsKitchen safety under review — supervised cooking until the OT assessment lands; Driving — documented discussion held; formal assessment referred

Test yourself

Which screening tool fits the question?

The teaching

PD-MCI is an early, executive-first syndrome, and the MDS criteria plus a MoCA or SCOPA-COG are how it is named rather than hinted at. It changes physiotherapy because gait is attentional: dual-task cost is measurable, trainable with instruction and practice, and dangerous when ignored — and safety questions like the stove and the car belong in the plan, documented. What you do with it: screen with the instrument that sees executive dysfunction, grade dual-task work from corridors to car parks, keep single-task rules where falls would land, and refer the driving question formally instead of hoping it.

  • Any further kitchen or driving incident — escalate to neurology and occupational therapy the same week
  • Hallucinations, fluctuating confusion or rapid cognitive change — this is not routine PD-MCI; medical review

Read next

The full sequence

This page carries the case’s first decision. The full sequence — every decision, the examination by domain, and the debrief that grades you — is in the drill, and the library is included with membership.

Sources on this page: Litvan I et al. Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society task force guidelines. Mov Disord. 2012. Dalrymple-Alford JC et al. The MoCA: well-suited screen for cognitive impairment in Parkinson disease. Neurology. 2010. Muslimovic D et al. Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology. 2005 · Yogev-Seligmann G et al. The role of executive function and attention in gait. Mov Disord. 2008. Rochester L et al. Neuroscience. 2014. Murray DK et al. Transl Neurodegener. 2014