Cognitive impairment in Parkinson’s disease: prevalence and associations with cardiometabolic, vascular, and autonomic factors—a systematic review and meta-analysis

Cognitive impairment is a common and disabling non-motor manifestation of Parkinson’s disease (PD), but its prevalence and associated factors remain unclear. This systematic review and meta-analysis aimed to estimate the pooled prevalence of cognitive impairment in PD and identify associated clinical factors. We searched electronic databases for observational studies and performed random-effects meta-analyses with subgroup analyses, sensitivity analyses, publication bias assessment, and GRADE evaluation.

Fifty-five studies involving 103,145 participants were included. The pooled prevalence of cognitive impairment was 32.7% (95% CI: 27.1–38.7%), with substantial heterogeneity (I² = 97.7%). Prevalence varied according to diagnostic criteria and assessment tools.

Orthostatic hypotension (OR = 2.18, 95% CI:1.71–2.77) and advanced age were strongly associated with cognitive impairment, while diabetes, hypertension, and metabolic syndrome showed additional associations. Evidence certainty ranged from low to very low. Cognitive impairment affects approximately one-third of individuals with PD, highlighting the need for early screening and longitudinal research.

The authors thank all researchers whose studies contributed to this systematic review and meta-analysis. This work was supported by the Shenzhen Science and Technology Program (Grant No. The funder had no role in the study design, data collection, analysis, interpretation of results, or writing of the manuscript.

These authors contributed equally: Jiang Wang, Hongshuai Zhou, Tian Tian. School of Basic Medicine, Jinggangshan University, Ji’an, China Jiang Wang, Hongshuai Zhou, Tian Tian, Jian Liao, Hao Zeng, Yibin Hu, Xiaotao Liang & Ziqian Guo Online Collaborative Research Center for Evidence-Based Medicine, Ministry of Education, Jinggangshan University Branch, Ji’an, China School of Chinese Medicine, Jinggangshan University, Ji’an, China School of Clinical Medicine, Jinggangshan University, Ji’an, China Yutong Wu, Jiahui Bian, Zhiqi Jiang, Wenshu Chen, Maolin Zou, Xiaotong Sun, Jiacheng Zhang, Jiayi Zeng & Zuliang Gu School of Nursing, Jinggangshan University, Ji’an, China Haotian Zhou, Yuchang Liang, Keqin Luo, Huixue Zuo, Zhixuan Zhou, Wenting Zhang & Xin Jiang Department of Emergency Medicine, The People’s Hospital of Baoan Shenzhen, Shenzhen, China Correspondence to Jiang Wang or Xiaoming Zhang. The authors declare no competing interests.

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