Risk of cognitive impairment or dementia in relatives of patients with Parkinson disease
Risk of cognitive impairment or dementia in relatives of patients with Parkinson disease
复制标题
DOI：
10.1001/archneur.64.10.1458
复制
发表时间：
2007-10-01
影响因子：
--
通讯作者：
Maraganore, Demetrius M.
中科院分区：
文献类型：
--
作者：
Rocca, Walter A.;Bower, James H.;Maraganore, Demetrius M.
背景资料：帕金森病（PD）患者亲属痴呆风险增加的证据仍然存在矛盾。目的：研究PD患者一级亲属认知功能障碍或痴呆的风险。设计、设置和参与者：我们对1019名第一次-一级亲属的162例PD患者和858名亲属的147个匹配的对照组的人口的奥姆斯特德县，明尼苏达州的代表。此外，我们还研究了转介到马约诊所的411名PD患者的2716名一级亲属。主要结果测量：我们通过电话直接对亲属进行认知测试，或对代理人进行痴呆症调查问卷。对于代理人报告的患有痴呆症的亲属，我们获得了他们的医疗记录副本以确认诊断。结果：在以总人口为基础的样本中，与对照组的亲属相比，PD患者的亲属发生认知障碍或痴呆的风险增加（危害比，1.37; 95%可信区间，1.03-1.81; P= 0.03），尤其是在66岁或更年轻的PD患者的亲属中增加（最年轻的三分位数;风险比，1.73; 95%置信区间，1.21-2.46; P= 0.003）。几项敏感性分析的结果一致。在以家族为基础的样本中，认知功能障碍或痴呆的风险增加，在发病时的PD，但没有改变其他临床feature.Conclusion：认知功能障碍或痴呆可能与PD（遗传性或非遗传性）的家族易感因素。
Background: The evidence for increased risk of dementia in relatives of patients with Parkinson disease (PD) remains conflicting.Objective: To study the risk of cognitive impairment or dementia in first-degree relatives of patients with PD.Design, Setting, and Participants: We conducted a historical cohort study of 1019 first-degree relatives of 162 patients with PD and of 858 relatives of 147 matched controls representative of the population of Olmsted County, Minnesota. In addition, we studied 2716 first-degree relatives of 411 patients with PD referred to Mayo Clinic.Main Outcome Measures: We administered via telephone a cognitive test directly to relatives or a dementia questionnaire to proxies. For relatives reported by proxies to have dementia, we obtained copies of their medical records to confirm the diagnosis. We also obtained dementia information from a medical records-linkage system.Results: In the overall population-based sample, the risk of cognitive impairment or dementia was increased in relatives of patients with PD compared with relatives of controls (hazard ratio, 1.37; 95% confidence interval, 1.03-1.81; P=.03) and was particularly increased in relatives of patients with onset of PD at age 66 years or younger ( youngest tertile; hazard ratio, 1.73; 95% confidence interval, 1.21-2.46; P=.003). The findings were consistent in several sensitivity analyses. In the referral-based sample, the risk of cognitive impairment or dementia in relatives increased with younger age at onset of PD but did not vary by other clinical characteristics.Conclusion: Cognitive impairment or dementia may share familial susceptibility factors with PD ( genetic or nongenetic).