轻度帕金森样体征对老年患者认知功能的影响

Effect of mild Parkinsonian signs on cognitive function in elderly patients

目的探讨轻度帕金森样体征(mild Parkinsonian signs, MPS)对住院老年患者认知功能的影响。方法选取2015-07—2019-06在东部战区总医院老年神经科住院患者,进行帕金森病评定量表-Ⅲ(Unified Parkinson’s Disease Rating ScaleⅢ,UPDRSⅢ)评估及认知功能评估并作为基线,随访3 a,每年对患者进行UPDRSⅢ、认知功能评估且数据完整。纳入97例MPS患者及97例非MPS患者。采取巢式病例对照分析MPS对老年患者认知功能的影响。结果基线时MPS组高血压、冠心病、糖尿病患病率高于非MPS组,词语学习、延迟回忆、动物流畅、符号数字转换评分MPS组显著低于非MPS组;相关性分析显示,简易精神状态检查量表评分(r=0.178,P=0.014)、词语学习(r=0.188,P=0.009)、延迟回忆(r=0.196,P=0.007)、动物流畅(r=0.177,P=0.015)、符号数字转换(r=0.337,P=0.000)与MPS显著相关。随访3 a后MPS组认知功能较非MPS组显著减退(P<0.05)。结论 MPS可加速住院老年患者认知功能减退,早期识别及预防可延缓疾病的发生、进展。

Objective To investigate the effect of mild Parkinsonian signs(MPS)on cognitive function in elderly hospitalized patients.Methods The patients who were hospitalized in the Department of Geriatric Neurology at the Eastern Theater General Hospital from July 2015 to June 2019 were selected.Parkinson’s Disease Rating ScaleⅢ(UPDRSⅢ)and cognitive function assessment as baseline,followed up for 3 years,UPDRSⅢand cognitive function assessment were conducted annually with complete data.Totally 97 MPS patients and 97 non-MPS patients were included.Nested case control was used to analyze the effect of MPS on cognitive function in elderly patients.Results At baseline,the prevalence of hypertension,coronary heart disease,diabetes in the MPS group was higher than that in the non-MPS group.Word learning,delayed recall,animal fluency,and symbol digit scores in the MPS group were significantly lower than those in the non-MPS group.Correlation analysis showed that MMSE(r=0.178,P=0.014),word learning(r=0.188,P=0.009),delayed recall(r=0.196,P=0.007),animal fluency(r=0.177,P=0.015),and symbol digit(r=0.337,P=0.000)were significantly correlated with MPS.After 3 years of follow-up,the cognitive function of the MPS group was significantly lower than that of the non-MPS group(P<0.05).Conclusion MPS can accelerate cognitive decline in hospitalized elderly patients,and early identification and prevention can delay the occurrence and progression of the disease.