Objective To explore the prevalence of sialorrhea and its clinical correlation with dysphagia in Chinese patients with Parkinson′s disease ( PD ).Methods One hundred and sixteen consecutive patients with a clinical diagnosis of PD were selected.Demographic data included sex , age, years of education, age at onset of PD, clinical genotype, disease duration, treatment, Hoehn and Yahr (H&Y) stage.Sialorrhea was assessed using the Unified Parkinson′s Disease Rating Scale (UPDRS) Ⅱitem number 6.All patients were studied with videofluoroscopic study of swallowing ( VFSS).Results The prevalence rate of sialorrhea in PD was 59.5% (69/116, 95% CI 50.6%-68.4%).Males were more likely to develop sialorrhea than females (47/70 vs 22/46,χ2 =4.298, P=0.038).PD patients′sialorrhea correlated with oral dysphagia:with food leaking from the mouth ( liquid r=0.229, P=0.014; juice r=0.197, P=0.034;pudding viscosities r=0.231, P=0.013;solid food r=0.255, P=0.006), with more than 1 ml of oral food residues (liquid r=0.319, P<0.01;solid food r=0.185, P=0.047), with delay in food transfer to the root of the tongue (liquid r=0.279, P=0.002; juice r=0.209, P=0.024), and delayed swallow transfer ( pudding viscosities r=0.257, P=0.005).Sialorrhea score was not related to H&Y stage, clinical course and levodopa equivalent doses (LED).The prevalence rate of dysphagia in PD was 87.1%(95% CI 81.0% -93.2%).Liquid was more likely to cause pharyngeal dysphagia ( P=0.03).With the increase in H&Y stage , so did the oral and pharyngeal stages of dysphagia.Late and mid-course was more likely to develop oral and pharyngeal dysphagia than those with early clinical course .Conclusions Sialorrhea and dysphagia are common non-motor symptoms in PD patients.Sialorrhea is more prevalent in males and correlates with oral phase of dysphagia.Liquid is more likely to cause pharyngeal dysphagia.With increase in H&Y stage , so did oral and pharyngeal dysphagia.Even though late clinical course is more likely to develop oral and pharyngeal dysphagia than early clinical course , the comparison between late and intermediate clinical courses does not reach statistical significance .

Objective:To investigate the characteristics of Parkinson's disease (PD)combined with orthostatic hypotension (OH)and the impact of the condition on cognitive function.Methods:A total of 210 PD patients admitted to Beijing Tiantan Hospital were consecutively enrolled.Demographic data and clinical characteristics were recorded.Patients were divided into the PD with OH (PD-OH)group and the PD without OH (PD-NOH)group based on blood pressure values measured in both the supine and upright positions.Cognitive function of PD patients was evaluated using the Mini-Mental State Examination (MMSE)and Montreal Cognitive Assessment (MoCA)scales.Results:Of 210 PD patients, 68 (32.4%)had OH.Patients in the PD-OH group had a higher mean age (69.7±8.9 years vs.62.1±11.3 years), longer disease duration [5.0 (3.0-8.0)years vs.4.0 (2.0-6.0)years], a higher incidence of diabetes (30.9% vs.17.4%), higher levels of fasting blood glucose (5.3±1.1 mmol/L vs.5.0±1.0 mmol/L)and glycated hemoglobin A1c (6.1±0.9% vs.5.7±0.7%), and more advanced Hoehn-Yahr staging [stage 2.5 (2.0-3.0) vs.stage 2.0 (1.5-2.5)]than the PD-NOH group ( P<0.05). The total scores of the MMSE and MoCA scales were lower in the PD-OH group than in the PD-NOH group (25.1±4.9 scores vs.26.8±4.0 scores, 19.4±5.4 scores vs.21.4±5.3 scores, P<0.05). A comparison of each cognitive domain of the MMSE scale between the two groups revealed that the scores of attention and calculation (3.7±1.7 scores vs.4.2±1.3 scores), delayed recall (2.1±1.0 scores vs.2.5±0.8 scores)and visuospatial ability (0.6±0.5 scores vs.0.7±0.5 scores)were lower in the PD-OH group than in the PD-NOH group ( P<0.05). A comparison of each cognitive domain of the MoCA scale between the two groups displayed that the scores of visuospatial and executive function (2.4±1.6 scores vs.2.9±1.7 scores)and delayed recall (1.3±1.4 scores vs.2.3±1.6 scores)were lower in the PD-OH group than in the PD-NOH group ( P<0.05). Logistic regression analysis showed that age ( OR=1.061, 95% CI: 1.022-1.102, P=0.002)and score of delayed recall of the MoCA scale ( OR=0.690, 95% CI: 0.498-0.955, P=0.025)were independent related factors for PD-OH. Conclusions:Compared with patients without OH, PD-OH patients are older and have a longer duration, increased disease severity, and a higher incidence of and more serious diabetes mellitus.Age is an independent related factor for PD-OH.Cognitive function is significantly impaired in PD-OH patients, and delayed recall is an independent related factor for PD-OH.

Objective: To investigate the clinical characteristics of sleep disorders(SD)in patients with Alzheimer's disease(AD), and the relationship between SD and cognitive impairment. Methods: According to the inclusion and exclusion criteria of AD, 89 consecutive AD patients admitted to Beijing Tiantan Hospital from January 2016 to January 2017 were included.The Pittsburgh sleep quality index(PSQI)scale was used to evaluate the overall sleep status.The patients were randomized into the AD with SD(AD-SD)group(PSQI>7)and the AD without SD(AD-NSD)group(PSQI<7). The cognitive function of AD patients was evaluated by the Montreal cognitive assessment(MoCA)scale, and the overall cognitive function and cognitive domains were compared between the AD-SD and AD-NSD groups. Results: Of the 89 AD patients, 71 cases(79.78%)had SD.There was no significant difference in gender, age, age of onset, education level and disease duration between the AD-SD and AD-NSD groups(P>0.05). The factors in the PSQI scale had significant differences between AD-SD和AD-NSD groups, including sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, administration of sleeping medication and daytime dysfunction(P<0.05). Compared with the AD-NSD group, the AD-SD group showed that the total score of MoCA scale was significantly reduced(P<0.05), and the scores of delayed recall and language were significantly decreased(P<0.05). There was a negative correlation of the sleep time with the total score of MoCA scale and the score of delayed recall in the AD-SD group(r=-0.245 and -0.249, P=0.041 and 0.039). Night SD was negative correlated with the total score of MoCA scale and the score of delayed recall(r=-0.248 and -0.283, P=0.038 and 0.018). Conclusions The incidence of AD-SD is up to 79.78%.AD-SD patients have a worse subjective sleep quality, longer time to fall asleep, shorter sleep time, lower sleep efficiency, higher night SD, more use of sleep drugs and more daytime dysfunction.General cognitive dysfunction, delayed recall and language impairment are more obvious in AD-SD patients.In AD-SD group, longer time to fall asleep and night SD are related to the general cognitive function and delayed recall.