老年帕金森病患者认知功能损害的特点及相关因素分析

Characteristics and related factors of cognitive impairment in elderly PD patients

目的分析老年帕金森病患者认知功能损害的特点及相关因素。方法选择2018年2月~2020年12月就诊于解放军总医院帕金森病门诊的老年帕金森病患者66例,根据简易智能状态检查量表(MMSE)评分分为认知正常组38例和认知损害组28例。采用统一帕金森病评定量表(UPDRS)、Hoehn-Yahr(H-Y)分级、帕金森病生活质量问卷39项(PDQ39)评估患者运动症状、生活能力和生活质量。结果认知损害组受教育时间明显低于认知正常组,差异有统计学意义(P<0.01)。多因素logistic回归分析显示,受教育时间是帕金森病患者认知功能损害的保护因素(OR=0.644,95%CI:0.490~0.846,P=0.002)。帕金森病患者MMSE总分、时间定向力、延迟回忆、语言功能与H-Y分级、PDQ39总分、UPDRS-Ⅰ、UPDRS-Ⅱ、UPDRS-Ⅲ评分中等程度相关(P<0.05)。结论帕金森病患者认知功能与其受教育时间、疾病严重程度和生活质量有关。

Objective To analyze the characteristics and related factors of cognitive impairment in elderly PD patients.Methods Sixty-six elderly PD patients who visited the PD Clinic of our hospital from February 2018 to December 2020 were divided into normal cognitive group(n=38)and cognitive impairment group(n=28)according to their MMSE scale score.Their motor symptoms,ability of life and quality of life were assessed according to their unified PD rating scale(UPDRS)score,Hoehn-Yahr(H-Y)grading and PD questionnaire 39(PDQ39)score respectively.Results The education time was significantly shorter and the MMSE scale score was significantly lower in cognitive impairment group than in normal cognitive group(P<0.01).Multivariate logistic regression analysis showed that education time was a protective factor for cognitive impairment in PD patients(OR=0.644,95%CI:0.490-0.846,P=0.002).The total MMSE scale score,time orientation,delayed recall and language function were moderately related with the H-Y grading,total PDQ39 score,and UPDRS score in PD patients(P<0.05).Conclusion The cognitive function in PD patients is related with their education time,severity of PD and quality of life.