Cognitive Impairment in Parkinson Disease: Impact on Quality of Life, Disability, and Caregiver Burden
Cognitive Impairment in Parkinson Disease: Impact on Quality of Life, Disability, and Caregiver Burden
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DOI：
10.1177/0891988712464823
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发表时间：
2012-12-01
影响因子：
2.6
通讯作者：
Harbishettar, Vijay
中科院分区：
文献类型：
--
作者：
Leroi, Iracema;McDonald, Kathryn;Harbishettar, Vijay
目的：比较轻度认知障碍（PD- mci）、痴呆（PDD）和无认知障碍（PD- nc）三组帕金森病（PD）患者的生活质量、残疾水平和照顾者负担。背景：虽然PD-MCI和PDD患者的认知状况已经得到了很好的描述，但对认知障碍的个人和临床影响及其对护理者的影响知之甚少。方法：对3组PD患者（PD- nc, n = 54; PD- mci, n = 48； PDD, n = 25）的生活质量和残疾进行测量。PD-MCI组使用运动障碍协会工作组共识标准进行分类。采用Zarit负担量表对3组护理人员（n = 102）进行评估。结果：两组无痴呆患者的生活质量和照顾者负担相似，而PDD患者的生活质量和照顾者负担差异有统计学意义。相比之下，在3个PD组中，随着认知能力的下降，整体残疾逐渐加重：PD- nc < PD- mci < PDD，在日常生活活动量表上，任何认知障碍的存在都可以看到障碍的加剧。结论：痴呆的存在显著增加了照顾者的负担，降低了生活质量。然而，即使是轻度的认知障碍也会增加残疾，而整体功能障碍的进展与认知能力下降是同步的。
Aim: To compare quality of life, level of disability, and caregiver burden in 3 groups of people with Parkinson disease (PD): those with mild cognitive impairment (PD-MCI), those with dementia (PDD), and those with no cognitive impairment (PD-NC). Background: Although the cognitive profile of those with PD-MCI and PDD has been well described, little is known about the personal and clinical impact of cognitive impairment and its impact on caregivers. Method: Quality of life and disability were measured in 3 groups of participants with PD (PD-NC, n = 54; PD-MCI, n = 48; and PDD, n = 25). The PD-MCI group was classified using Movement Disorder Society Task Force consensus criteria. Caregivers (n = 102) in the 3 groups were assessed using the Zarit Burden Inventory. Results: Both quality of life and caregiver burden were similar in the 2 groups without dementia but were significantly different in those with PDD. In contrast, global disability was progressively greater as cognition declined across the 3 PD groups: PD-NC < PD-MCI < PDD and on the Activities of Daily Living scale a step up in impairment was seen with the presence of any cognitive impairment. Conclusions: The presence of dementia significantly increases caregiver burden and decreases quality of life. However, even mild levels of cognitive impairment increase disability and overall functional impairment progresses in tandem with cognitive decline.