军队离退休老干部帕金森病认知功能障碍现况调查

Investigation of cognitive dysfunction in Parkinson′s disease among retired veteran cadre of the Chinese army

目的了解中国军队离退休老干部帕金森病(PD)及PD认知障碍(PD-CI)的粗患病率,分析PD的患病率及PD患者认知障碍的神经心理评估特点。方法全国性的横断面调查研究,纳入平台研究9676人,其中确诊为PD患者227例(2.35%)。采用面对面调查,完善社会人口学资料及多种神经精神量表,分析PD及其相关认知障碍的患病率及PD认知障碍的特点。采用SPSS 19.0软件进行数据分析。组间比较采用χ2检验或Fisher精确检验;组内比较采用Dunn′s检验。结果中国军队离退休老干部帕金森病轻度认知障碍(PD-MCI)患者104例(45.8%),帕金森病痴呆(PDD)患者71例(31.3%)。PD-CI患病率随年龄增长及受教育年限的减少呈显著递增的变化趋势(P<0.05)。PD-MCI与PDD患者注意力、语言功能、执行功能、记忆功能及视空间功能比较,差异有统计学意义(P<0.05);PD-MCI与PDD患者计算功能比较,差异无统计学意义(P>0.05)。PD-CI针对患者语言功能及执行功能损伤的不同量表评分阳性患病率比较,差异有统计学意义(P<0.05);组内比较提示命名测验及画钟测验检测出的阳性患病率最高(P<0.05)。PDD患者命名、词语流畅性及听指令执行配合困难发生率比较,差异无统计学意义(P>0.05);针对执行功能的多个量表的配合困难发生率比较,差异有统计学意义(P<0.05);组内比较提示画钟测验与另4组配合困难的发生率比较,差异有统计学意义(P<0.05)。结论PD患者认知功能障碍患病率较高,了解PD认知功能障碍的特点并合理的选择神经心理学评估量表尤为重要。

Objective To understand the crude prevalence of Parkinson′s disease(PD)and Parkinson′s disease with its cognitive impairment(PD-CI)in the retired veteran cadre of the Chinese army and to analyze the prevalence of PD and the characteristics of neuropsychological assessment of its cognitive impairment.Methods This nationwide cross-sectional survey included 9676 people in the platform study,of whom 227(2.35%)were diagnosed with PD.Face-to-face surveys were used to improve sociodemographic data and various neuropsychological scales,to analyze the prevalence of PD and related cognitive impairments,and the characteristics of PD cognitive impairments.SPSS statistics 19.0 was used for data analysis.Data comparison among three or four groups was performed usingχ2 test or Fisher exact test;and Dunn′s test was employed for the intra-group comparison.Results Among 227 PD patients,104(45.8%)had PD mild cognitive impairment(PD-MCI)and 71(31.3%)had Parkinson′s disease dementia(PDD).The incidence of PD-CI increased with age and decrease in the schooling years(P<0.05).PD-MCI and PDD patients had significant difference in attention,language function,executive function impairment,memory function and visuospatial function(P<0.05)but no significant difference in calculation function(P>0.05).The difference in the scores on different scales for PD cognitive impairment in patients with language function and executive function was statistically significant(P<0.05).Intra-group comparison suggested the highest detection rates of the positivity by the naming test and the drawing clock test(P<0.05).There was no statistically significant difference in the incidence of naming,word fluency,and difficulty in observing instructions in patients with PDD(P>0.05).There was a statistically significant difference in the incidence of difficulty in coordination among multiple scales of executive function(P<0.05).The intra-group comparison suggested that the clock drawing test has a statistically significant difference in the incidence of difficulty in coordination with the other 4 groups(P<0.05).Conclusion The prevalence of cognitive dysfunction is high in patients with Parkinson′s disease.It is important to understand the characteristics of PD and to choose appropriate neuropsychological assessment scale.