具有认知减退主诉的帕金森病患者的认知、临床特征及相关因素分析

Analysis of cognitive,clinical characteristics and related factors of Parkinson’s disease patients with cognitive decline complaints

目的探讨具有认知减退主诉帕金森病(PD)患者的认知、临床特征及其相关因素。方法收集2020年1月至2021年12月期间在解放军总医院神经内科PD门诊就诊的具有认知减退主诉的PD患者129例,依据MMSE得分,分为认知正常组(74例)和认知损害组(55例)。采用自设调查表采集患者人口学信息、疾病相关信息及生活方式,所有患者均进行39项PD生活质量问卷、国际PD和运动障碍协会修订版统一PD评定量表(MDS-UPDRS)、改良Hoehn-Yahr分级、汉密尔顿焦虑量表、汉密尔顿抑郁量表(HAMD)、PD睡眠量表-2的测评。采用二元Logistic回归分析对PD患者认知功能损害的相关因素进行探讨。结果本组PD患者中认知功能损害者占42.6%(55/74)。二元Logistic回归分析结果显示,受教育时间、运动锻炼、社交活动是PD患者认知功能损害的保护因素,而高HAMD评分、睡眠障碍、高UPDRS-Ⅲ评分是PD患者认知功能损害的独立危险因素(均P<0.05)。结论受教育时间、运动锻炼、社交活动是PD患者认知功能损害的保护因素,而睡眠障碍、抑郁、高UPDRS-Ⅲ评分是PD患者认知功能损害的独立危险因素,针对这些因素制定干预策略可能改善其认知功能、提高生活质量。

Objective To investigate the cognitive,clinical characteristics and related factors of Parkinson’s disease(PD)patients with cognitive decline complaints.Methods A total of one hundred and twenty-nine PD patients with cognitive decline complaints,who visited the PD Clinic of our hospital from January 2020 to December 2021,were analyzed.They were divided into normal cognitive group(n=74)and cognitive impairment group(n=55)according to their MMSE scores.Demographic data,disease-related information and lifestyle were collected using self-designed questionnaires.All patients were assessed by 39-item PD Questionnaire,movement disorder society-sponsored revision of the unified PD rating scale(MDS-UPDRS),modified Hoehn-Yahr grading,Hamilton rating scale for depression(HAMD),Hamilton rating scale for anxiety and PD sleep scale-2.Multivariate binary Logistic regression analysis was used to explore the influencing factors of cognitive impairment in PD patients.Results The proportion of cognitive impairment in PD patients in this group was 42.6%(55/74).Binomial Logistic regression analysis showed that the length of education,exercise and social activities were protective factors for cognitive impairment in PD patients,while high HAMD score,sleep disturbance and high UPDRS-Ⅲscore were risk factors for cognitive impairment in PD patients(all P<0.05).Conclusions The length of education,exercise and social activities are protective factors for cognitive impairment in PD patients,while sleep disturbance,high UPDRS-Ⅲscore and depression are risk factors for cognitive impairment in PD patients.Intervention strategies targeting these factors may improve cognitive function and quality of life.