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Scales for Outcomes in Parkinson's Disease-Cognitive (SCOPA-COG)
Please visit this website for more information about the instrument: Scales for Outcomes in Parkinson's Disease-Cognitive
To request permission to use this scale, the International Parkinson and Movement Disorder Society permission request form needs to be filled out.
Supplemental: Parkinson's Disease (PD)
Short Description of Instrument
Purpose: The SCOPA-COG is a global cognitive scale developed to evaluate cognitive impairment specific to PD. It was designed for comparing groups in research situations, not as a screening or diagnostic tool (Marinus et al., 2003).
Overview: The scale covers the domains of memory, attention, visuospatial functions, and executive abilities.
Verbal and visual memory: Cube test (reproducing the sequence in which four cubes are pointed), backward digit span, and immediate/delayed recall of ten words
Attention: Months backward and serial three subtractions.
Executive function: Luria three-step motor, set-shifting, and semantic fluency (animals)
Visuospatial function: Figure assembly
The administration (paper-pencil) takes approximately 15 minutes. It does not have alternate versions.
Comments/Special Instructions
The SCOPA-COG can be used for screening (although it was not specifically designed for this), severity, and correlative studies, but is not suitable as an outcome measure in treatment trials because of its poor responsiveness to change.
Scoring and Psychometric Properties
Scoring: 4 points attention; 22 points memory; 12 points executive function; 5 points visuospatial. The maximum score is 43 (higher score indicates better performance): Verbal and visual memory (22), attention (4), executive function (12), visuospatial (5). There are no cut-off scores for dementia or mild cognitive impairment (MCI). Although the SCOPA-Cog was not designed to be a diagnostic instrument, some have proposed cutoff scores for PD-MCI and PD-dementia (Isella et al., 2013): PD-MCI vs. PD no cognitive impairment  <24 (sensitivity 0.90; specificity 0.73), and PD-MCI versus PD-dementia <17 (0.93, 0.97).
The total score correlates with disease severity (Marinus et al., 2003).
Psychometric Properties:
-Good construct validity supported by correlations with other global scales and by differences between groups of patients classified by dementia status and disease severity (Marinus et al., 2003).
-Good internal consistency, Cronbach's alpha = 0.78 (Serrano-Dueñas et al., 2010)-0.83 (Marinus et al., 2003)
-Good test-retest reliability (0.78) (Marinus et al., 2003)
-Inter-rater reliability was not assessed
Forjaz et al. (2010), based on Rasch analyses, questioned construct validity of the subscales and noted SCOPA-COG is a unidimensional measure of global cognitive function in PD with good scale targeting but no empirical evidence for use of the subscale scores
The SCOPA-COG has been used as a cognitive measure in longitudinal studies (Zhu et al., 2014; Wills et al., 2016). However, compared with gold standard neuropsychological assessment, its performance for detecting decline in non-demented PD patients over a 1-year interval has been poor (Faust-Socher et al., 2019).  
-Easy to administer  
-Lack of floor or ceiling effects
-Does not have alternate versions
-Weighted toward memory with limited coverage of attention and language (Skorvanek et al., 2018)
-Poor sensitivity to change (Faust-Socher et al., 2019
-Lack of information on inter-rater reliability
Key Reference:
Marinus J, Visser M, Verwey NA, Verhey FR, Middelkoop HA, Stiggelbout AM, van Hilten JJ. Assessment of cognition in Parkinson's disease. Neurology. 2003 Nov 11;61(9):1222-8.
Additional References:
Faust-Socher A, Duff-Canning S, Grabovsky A, Armstrong MJ, Rothberg B, Eslinger PJ, Meaney CA, Schneider RB, Tang-Wai DF, Fox SH, Zadikoff C, Kennedy N, Chou KL, Persad C, Litvan I, Mast BT, Gerstenecker AT, Weintraub S, Reginold W, Marras C. Responsiveness to Change of the Montreal Cognitive Assessment, Mini-Mental State Examination, and SCOPA-Cog in Non-Demented Patients with Parkinson's Disease. Dement Geriatr Cogn Disord. 2019;47(4-6):187-197.
Forjaz MJ, Frades-Payo B, Rodriguez-Blazquez C, Ayala A, Martinez-Martin P; Longitudinal Parkinson's Disease Patient Study, Estudio longitudinal de pacients con enfermedad da Parkinson Group. Should the SCOPA-COG be modified? A Rasch analysis perspective. Eur J Neurol. 2010 Feb;17(2):202-7.
Serrano-Dueñas M, Calero B, Serrano S, Serrano M, Coronel P. Metric properties of the mini-mental Parkinson and SCOPA-COG scales for rating cognitive deterioration in Parkinson's disease. Mov Disord. 2010 Nov 15;25(15):2555-62.
Skorvanek M, Goldman JG, Jahanshahi M, Marras C, Rektorova I, Schmand B, van Duijn E, Goetz CG, Weintraub D, Stebbins GT, Martinez-Martin P; members of the MDS Rating Scales Review Committee. Global scales for cognitive screening in Parkinson's disease: Critique and recommendations. Mov Disord. 2018 Feb;33(2):208-218.
Isella V, Mapelli C, Morielli N, Siri C, De Gaspari D, Pezzoli G, Antonini A, Poletti M, Bonuccelli U, Picchi L, Napolitano A, Vista M, Appollonio IM. Diagnosis of possible mild cognitive impairment in Parkinson's disease: validity of the SCOPA-Cog. Parkinsonism Relat Disord. 2013 Dec;19(12):1160-3.
Wills AA, Elm JJ, Ye R, Chou KL, Parashos SA, Hauser RA, Bodis-Wollner I, Hinson VK, Christine CW, Schneider JS; NINDS NET-PD Investigators. Cognitive function in 1736 participants in NINDS Exploratory Trials in PD Long-term Study-1. Parkinsonism Relat Disord. 2016 Dec;33:127-133.
Zhu K, van Hilten JJ, Marinus J. Predictors of dementia in Parkinson's disease; findings from a 5-year prospective study using the SCOPA-COG. Parkinsonism Relat Disord. 2014 Sep;20(9):980-5.
Document last updated August 2022