Prediction of cognitive progression in Parkinson's disease using three cognitive screening measures.
Prediction of cognitive progression in Parkinson's disease using three cognitive screening measures.
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DOI：
10.1016/j.prdoa.2019.08.006
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发表时间：
2019-01-01
期刊：
影响因子：
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通讯作者：
Cholerton, Brenna
中科院分区：
文献类型：
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作者：
Kim, Hojoong M;Nazor, Carter;Cholerton, Brenna
简介：认知障碍是帕金森病（PD）的常见并发症，识别进展为帕金森病痴呆（PDD）的危险因素非常重要。然而，很少有研究已经做了比较常用的认知筛查测试在预测认知进展PD.METHODS的效用：我们回顾性分析了数据，PD患者参加了太平洋尤德尔中心的基线和纵向神经心理学和全球认知筛查测试。比较3种常用的筛查方法：蒙特利尔认知评定量表（莫卡）、Mattis痴呆评定量表（DRS-2）和简易精神状态检查量表（MMSE）的诊断准确性。PD伴轻度认知障碍（PD-MCI）和PDD的认知诊断基于完整的神经心理学测试和已建立的运动障碍协会标准。Logistic回归和考克斯比例风险回归模型被用来检查预测认知能力下降。结果：四百七十例患者的评分，所有3个筛选测试，可从同一个评估被列入横断面分析。与DRS-2和MMSE相比，莫卡证明了PD-MCI（AUC= 0.79，灵敏度= 76.4%）和PDD（AUC= 0.89，灵敏度= 81.0%）的最佳总体诊断准确性。对基线时无痴呆且接受过两次或两次以上评估的患者亚组（316/470; 67.2%）进行了纵向分析。在控制协变量后，莫卡是唯一与PDD进展（OR= 1.27，95% CI 1.1 - 1.5，p=0.001）和更快的痴呆时间（HR = 1.3，95% CI 1.1 - 1.4，p
INTRODUCTION: Cognitive impairment is a common complication of Parkinson's disease (PD) and identifying risk factors for progression to Parkinson's disease dementia (PDD) is important. However, little research has been done comparing the utility of commonly used cognitive screening tests in predicting cognitive progression in PD.METHODS: We retrospectively reviewed data from patients with PD enrolled in the Pacific Udall Center who had baseline and longitudinal neuropsychological and global cognitive screening tests. The diagnostic accuracies of 3 common screening tests were compared: Montreal Cognitive Assessment (MoCA), Mattis Dementia Rating Scale (DRS-2), and Mini Mental Status Examination (MMSE). Cognitive diagnoses of PD with mild cognitive impairment (PD-MCI) and PDD were based on full neuropsychological testing and established Movement Disorder Society criteria. Logistic regression and Cox proportional hazards regression models were used to examine predictors of cognitive decline.RESULTS: Four hundred seventy patients for whom scores on all 3 screening tests were available from the same assessment were included in a cross-sectional analysis. The MoCA demonstrated the best overall diagnostic accuracy for PD-MCI (AUC= 0.79, sensitivity= 76.4%) and for PDD (AUC= 0.89, sensitivity= 81.0%) compared to the DRS-2 and MMSE. A longitudinal analysis was performed on the subset of patients (316/470; 67.2%) who were nondemented at baseline and had undergone two or more assessments. After controlling for covariates, the MoCA was the only test associated with progression to PDD (OR= 1.27 95% CI 1.1 - 1.5, p=0.001) and faster time to dementia (HR = 1.3, 95% CI 1.1 - 1.4, p