Prevalence and characteristics of dementia in Parkinson disease - An 8-year prospective study
Prevalence and characteristics of dementia in Parkinson disease - An 8-year prospective study
复制标题
DOI：
10.1001/archneur.60.3.387
复制
发表时间：
2003-03-01
影响因子：
--
通讯作者：
Kragh-Sorensen, P
中科院分区：
文献类型：
--
作者：
Aarsland, D;Andersen, K;Kragh-Sorensen, P
背景资料：帕金森病（PD）的痴呆的纵向研究很少有报道，PD患者最终发展为痴呆的比例是unknown.Objective：为了研究8年的患病率，特点和痴呆的危险因素在PD patients.Methods：患者被招募的PD在挪威的罗加兰县的流行病学研究，使用明确的PD标准。排除了在疾病发作时有认知障碍的受试者。根据《精神疾病诊断和统计手册》第三版修订版的标准，在基线和4年及8年后，采用半结构化的基于护理人员的访谈、认知评定量表和神经心理学测试来诊断痴呆。一个基于人口的样本3295名受试者在欧登塞市，丹麦，被用作对照组，并在基线和2年和5年后进行检查。基线时，51例患者（26%）患有痴呆症。55名患者死亡，10名患者拒绝随访，而他们的痴呆状态未知。在4年和8年的评估中，分别确定了43例和28例新的痴呆症病例。PD患者的4年痴呆患病率几乎是非PD组的3倍。PD的8年患病率为78.2%（95%置信区间[CI]，71.1-84.0）。痴呆的危险因素是基线前的幻觉（比值比[OR] = 3.1; 95%CI，1.6-6.2）和运动不能显性或混合震颤/运动不能PD（OR=3.3; 95%CI，1.2-8.5）。结论：在8年的研究期间，超过四分之三的代表性PD队列发展为痴呆。早期幻觉和运动不能型PD与痴呆风险增加相关。
Background: Few longitudinal studies of dementia in Parkinson disease (PD) have been reported, and the proportion of patients with PD who eventually develop dementia is unknown.Objective: To examine the 8-year prevalence, characteristics, and risk factors of dementia in patients with PD.Methods: Patients were recruited from an epidemiological study of PD in the county of Rogaland, Norway, using explicit criteria for PD. Subjects with cognitive impairment at disease onset were excluded. A semistructured care-giver-based interview, cognitive rating scales, and neuropsychological tests were used to diagnose dementia according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition at baseline and 4 and 8 years later. A population-based sample of 3295 subjects in the municipality of Odense, Denmark, was used as a comparison group and examined at baseline and after 2 and 5 years.Results: We included 224 patients with PD (116 women). At baseline, 51 patients (26%) had dementia. Fifty-five patients died, and 10 refused follow-up without their dementia status known. Forty-three and 28 new cases of dementia were identified at the 4- and 8-year evaluations, respectively. The 4-year prevalence of dementia in PD was nearly 3 times higher than in the non-PD group. The 8-year prevalence in PD was 78.2% (95% confidence interval [CI], 71.1-84.0). Risk factors for dementia were hallucinations before baseline (odds ratio [OR] = 3.1; 95% CI, 1.6-6.2) and akinetic-dominant or mixed tremor/akinetic PD (OR=3.3; 95% CI, 1.2-8.5).Conclusions: More than three quarters of this representative PD cohort developed dementia during the 8-year study period. Early hallucinations and akinetic-dominant PD were associated with an increased risk of dementia.