Cognitive profile of patients with newly diagnosed Parkinson disease
Cognitive profile of patients with newly diagnosed Parkinson disease
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DOI：
10.1212/01.wnl.0000180516.69442.95
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发表时间：
2005-10-25
期刊：
影响因子：
9.9
通讯作者：
Schmand, B
中科院分区：
文献类型：
--
作者：
Muslimovic, D;Post, B;Schmand, B
目的：确定新诊断帕金森病（PD）患者认知功能障碍的频率和模式，并确定其人口统计学和临床相关性。研究方法：一组115名新诊断的PD患者和70名健康对照者进行了全面的神经心理学评估，包括心理速度，注意力，语言，记忆，执行和视觉空间功能以及情感状态的测量。患者还接受了运动症状严重程度和功能状态的定量评级。PD患者的神经心理学表现与健康对照组和现有的规范性数据进行了比较。认知功能障碍的独立人口统计学和临床预测因素采用多元逻辑回归分析。结果：相对于对照组，PD患者在大多数认知测量中表现明显较差。然而，进一步的分析表明，认知表现的群体差异主要可以通过即时记忆和执行功能来解释。与正常数据的比较表明，执行功能，记忆和心理速度的措施最常见的损害。总体而言，24%的PD患者（对照组的4%）在至少三项神经心理学测试中表现出有缺陷的表现，并被归类为认知受损。迟发性疾病是PD患者认知功能障碍的独立预测因素。结论：即使在新诊断的帕金森病患者中，认知障碍也很常见，其中记忆和执行功能领域的缺陷最为突出。帕金森病患者发病年龄较大可能是认知功能障碍的重要决定因素。
Objective: To determine the frequency and pattern of cognitive dysfunction in patients with newly diagnosed Parkinson disease (PD) and to identify its demographic and clinical correlates. Methods: A cohort of 115 consecutive patients with newly diagnosed PD and 70 healthy controls underwent a comprehensive neuropsychological assessment including tests of psychomotor speed, attention, language, memory, executive and visuospatial functions, as well as measures of affective status. Patients also received quantitative ratings of motor symptom severity and functional status. Neuropsychological performance of PD patients was compared with that of healthy controls and with available normative data. Independent demographic and clinical predictors of cognitive impairment were identified with multiple logistic regression analysis. Results: Relative to controls, PD patients performed significantly worse on most cognitive measures. However, further analysis revealed that group differences in cognitive performance could mainly be explained by measures of immediate memory and executive function. Comparison with normative data showed that impairments were most frequent on measures of executive function, memory and psychomotor speed. In all, 24% of PD patients (4% of controls) displayed defective performance on at least three neuropsychological tests and were classified as cognitively impaired. Late onset of disease was an independent predictor of cognitive dysfunction in PD. Conclusion: Cognitive impairments are common even in newly diagnosed Parkinson disease patients, with deficits being most prominent in the domains of memory and executive functions. Older age at disease onset is likely to be an important determinant of cognitive dysfunction in Parkinson disease.