洛文斯顿作业疗法认知评定量表在无痴呆型帕金森病患者中的应用价值

Application value of Loewenstein occupational therapy cognitive assessment in patients with Parkinson disease without dementia

目的探讨洛文斯顿作业疗法认知评定量表(LOTCA)在无痴呆型帕金森病(PD)患者中的应用价值。方法采用简易精神状态检查(MMSE)量表及LOTCA对60例无痴呆型PD患者和50例对照者的认知功能进行检测,并对引起认知功能损害的相关因素进行分析。结果采用MMSE评分时,仅2例(3.3%)无痴呆型PD患者出现认知功能损害;采用LOTCA评分时,23例(38.3%)无痴呆型PD患者出现认知功能损害,主要累及视运动组织功能和思维运作能力。单因素分析显示:年龄、起病年龄、抑郁症、运动障碍的严重程度及类型与PD患者认知功能损害有关;多因素Logistic回归分析显示:年龄、抑郁、姿势不稳-步态异常(PIGD)型运动障碍是认知功能损害的危险因素。结论LOTCA量表适合无痴呆型PD患者认知功能的评定;老龄、抑郁状态及PIGD型运动功能障碍可能是影响无痴呆型PD患者的认知功能的危险因素。

Objective To investigate the application value of Loewenstein occupational therapy cognitive assessment（LOTCA）in patients with Parkinson disease（PD）without dementia.Methods The cognitive function of 60 PD patients without dementia and 50 controls were detected by Mini-Mental State Examination（MMSE）and LOTCA,and the relative factors which bring on cognitive impairment were analyzed.Results Of the 60 PD patients without dementia,2 cases（3.3%）were found cognitive impairment by MMSE,while 23 cases（38.3%）were found cognitive impairment by LOTCA,and which were mostly found in visuo-motor organization and thinking operation.The univariate analysis found that age,onset age,depression,dyskinetic severity and type were related with cognitive impairment.Multiplicity Logistic regression analysis showed that age,depression and posture-unsteadiness and gait-irregularity（PIGD）type of dyskinesia were risk factors of cognitive impairment.Conclusions LOTCA is suitable to assess the cognitive impairment in PD patients without dementia.Age,depression and PIGD type of dyskinesia may be the risk factors of influence on cognitive function in PD patients without dementia.