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This shift is driven primarily by the desire to improve long\u2010term outcomes by delivering therapeutic interventions earlier in the clinical course, even presymptomatically in those at highest risk, and at the initial stage in the pathophysiological cascade that underpins common dementia syndromes. This article focuses on key findings and challenges in studying earliest stages of cognitive decline in PD, including a detailed examination of neuropsychological testing, cognitive performance in early and prodromal PD, epidemiological research for PD mild cognitive impairment to date, and expert recommendations for assessment. \u00a9 2018 International Parkinson and Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.27330","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T10:25:48Z","timestamp":1521109548000},"page":"511-519","source":"Crossref","is-referenced-by-count":55,"title":["Initial cognitive changes in Parkinson's disease"],"prefix":"10.1002","volume":"33","author":[{"given":"Daniel","family":"Weintraub","sequence":"first","affiliation":[{"name":"Departments of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Parkinson's Disease and Mental Illness 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