The pot on the stove — cognition enters the plan
| Patient | 64F, early stage |
|---|---|
| ConditionIdiopathic Parkinson’s disease, H&Y II, with early cognitive change (suspected PD-MCI) | |
| Severity | UPDRS-III 24 |
| Days since diagnosis | 182 |
| 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