西安市帕金森病患者认知障碍特征调查

Study on the status of cognition among Parkinson＇ s disease patients in Xi＇ an

目的研究西安市帕金森病（PD）患者认知功能障碍特征及其影响因素。方法采用连续入组的方法，对2007年1—4月在西安市7家综合医院神经内科就诊的PD患者，应用简易精神状态量表（MMSE）和蒙特利尔认知评估（MOCA）评定整体认知功能，Fuld物体记忆测验评价延迟记忆，快速词汇测验评价语言流畅性，数字广度试验评价注意功能，积木试验评价视空间功能。结果共入选PD患者100例，其中男52例，女48例；年龄43～86（65．6±17．1）岁。以MMSE作为判断有无认知障碍的标准，16％的PD患者存在认知障碍；以MOCA作为判断有无认知障碍的标准，83％的PD患者存在认知障碍。PD患者MMSE或MOCA亚项评分下降幅度最大，低分率较高的认知域为计算力、短时记忆、视空间功能、抽象能力、注意和语言流畅性。logistic逐步同归分析发现与PD认知障碍相关的因素有文化程度（P=0．000）、发病年龄（P=0．039）和性别（Jp=0．018）。结论PD常合并认知障碍，且以计算、短时记忆、视空间、抽象、注意和语言流畅性障碍为主。高龄发病、低文化程度和女性PD患者更容易发生认知功能障碍。

Objective To study the characteristics and influencing factors of cognition on patients with Parkinson＇ s disease （PD） in Xi＇ an in order to provide evidence for early recognition and treatment of cognitive impairment on PD patients. Methods Clinically defined PD patients from 7 hospitals in Xi＇ an from Jan. to Apr. 2007 were assessed with mini-mental state examination （MMSE） and Montreal cognitive assessment （MOCA） for whole cognitive function. Furthermore, Fuld object memory test （FOM） was used to assess delayed memory while rapid verbal retrieve （RVR） was used to assess language fluency. Digit span subtest was used to assess attention and building blocks was used to assess visual space function respectively. Results 100 PD patients were recruited, including 52 men and 48 women, from 43 to 86 years old （65.6 _ 17.1 ）. MMSE scores was used as the standard for Recognition, PD with cognitive impairment accounted for 16%. According to MOCA scores, with PD cognitive disturbances accounted for 83%. Ability for calculation, short-term memory, visual space function, abstract capability, attention and language fluency dysfunction were main cognitive disturbances of PD. Analysis from single factor logistic regression showed that education, age of onset and gender were closely related to the occurrence of cognitive impairment on PD patients. Conclusion Cognitive impairment was common in PD. Ability of calculation, short-term memory, visual space function, abstract capability, attention and language fluency dysfunction were main cognitive disturbances of PD, Cognitive impairment of PD was more likely to occur with low degree of education, late onset of PD, and being female.