55岁以上自然人群中帕金森病患者认知功能障碍的临床研究

A clinical study on the cognitive impairment in patients with Parkinson's disease among natural population aged 55 years old and older

目的 了解 55岁以上自然人群中帕金森病 (Parkinson sdisease ,PD)患者认知功能障碍的发生情况。方法 以流行病学调查资料为基础 ,采用非配对的病例对照研究方法 ,分析 55岁以上自然人群中PD患者认知功能障碍的发生率 ,评估认知功能障碍发生的相对危险性。结果 55岁以上自然人群中 ,PD组和非帕金森病 (noParkinson sdis ease,NOPD)组认知功能障碍的发生率分别为 2 7.78%、5.55% ;年龄调整的发生率分别为 16.2 0 %、9.87%。与同一自然人群中NOPD组比较 ,PD组发生认知功能障碍的危险性明显增高 ,但主要增加低年龄组 (55～ 74岁 )中老年人发生认知功能障碍的危险性 (OR =8.59,95%CI :3 .13～ 2 3 .80 ) ;而且PD是低年龄中老年人发生认知功能障碍和痴呆的独立危险因素 (OR =6.2 7,95%CI :2 .3 5～ 19.2 7;OR =5.50 ,95%CI :1.52～ 19.94)。年龄调整的MMSE分值的均值PD组明显低于NOPD组 (P <0 .0 0 1)。结论 PD主要增加低年龄 (55～ 74岁 )中老年人认知功能障碍发生的危险性 。

Objective To understand the frequency and relativ e risk of cognitive impairment in patients with Parkinson's disease (PD) among natural population aged 55 years old and above. Methods Bas ed on the subjects with PD and without PD (NOPD) in the epidemiological data and by no matched-pair case-control method, the frequency of cognitive impairment in PD patients was calculated and its relative risk was estimated. Res ults Among the natural population aged 55 years old and above, the f requency of cognitive impairment in PD group and NOPD group was 27.78% and 5.55% , respectively. The age-adjusted frequency of both groups was 16.20% and 9.87 % , respectively. Compared with patients without PD, patients with PD had relat ively higher risk of cognitive impairment, especially in people aged 55～74 year s old ( OR=8.59, 95% CI:3.13～23.80 ). Moreover, PD was an independent risk fa ctor of cognitive impairment and dementia in the elderly aged 55～74 years old ( OR=6.27, 95%CI:2.35～19.27; OR=5.50, 95% CI :1.52～19.94). The aged-adju sted mean scores of MMSE in PD group were less than those in NOPD group( P < 0.001 ). Conclusion PD primarily increases risk of co gnitive impairment in 55～74 year-old people and its cognitive impairment is ca used by PD itself.