Clinical characteristics of mild cognitive impairment and its related risk factors in prodromal Parkinson's disease
10.3760/cma.j.cn115354-20200515-00369
- VernacularTitle:帕金森病前驱期轻度认知功能障碍的临床特点及相关影响因素分析
- Author:
Jianxia XU
1
;
Weiguo LIU
;
Ping HUA
;
Yong CHEN
;
Li ZHANG
;
Pingyi XU
Author Information
1. 南京医科大学附属脑科医院神经内科，南京 210029
- Keywords:
Parkinson's disease;
Prodromal stage;
Mild cognitive impairment;
Risk factor
- From:
Chinese Journal of Neuromedicine
2020;19(10):1001-1007
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the prevalence and clinical characteristics of mild cognitive impairment (MCI) and its related risk factors in patients with prodromal Parkinson's disease (pPD).Methods:Forty-seven pPD patients from Nanjing community and 37 healthy controls (HCs) were recruited in the present study. The pPD patients were divided into pPD-MCI group and normal cognition (pPD-NC) group according to Beijing version of Montreal Cognitive Assessment (BJ-MoCA). The general clinical data, Hamilton Depression Scale (HAMD) scores, Hamilton Anxiety Scale (HAMA) scores, number of patients with rapid eye movement-sleep behavior disorder (RBD), overall cognitive function and cognitive domain impairment of members from pPD group and HCs, pPD-MCI group and pPD-NC group were respectively compared. Risk factors for pPD-MCI were analyzed by multivariate Logistic regression analysis.Results:The prevalence of pPD-MCI in the 47 pPD patients was 57.45% (27/47). As compared with the HCs, pPD patients had significantly higher HAMD scores and HAMA scores, statistically larger number of patients with RBD, while significantly lower overall Montreal Cognitive Assessment (MoCA) scores and statistically lower scores in cognition domains of visuospatial and executive function, attention, abstraction, delayed memory and orientation ( P<0.05). Patients in pPD-MCI group had significantly higher HAMA scores, Unified Parkinson's Disease Rating Scale-Motor Examination scores, statistically lower education level, significantly lower MoCA scores, and statistically lower scores in cognition domains of visuospatial and executive function, abstraction, and delayed memory as compared with patients in pPD-NC group ( P<0.05). Multivariate Logistic regression analysis showed that low education level was an independent risk factor for pPD-MCI ( OR=0.800, 95%CI: 0.650-0.985, P=0.035). Conclusions:The prevalence of MCI in pPD patients is high, and multiple cognitive domains can be impaired in early stage. Patients with pPD-MCI are more vulnerable to depression and mild motor symptoms, so attention should be paid to emotional intervention and sport life guidance for patients at early stage. Education level is crucial for pPD-MCI, and cognitive training may contribute to slow down the process of MCI.
