Janvin Carmen Cristea, Larsen Jan Petter, Aarsland Dag, Hugdahl Kenneth
Stavanger University Hospital, Section of Geriatric Psychiatry, Stavanger, Norway.
Mov Disord. 2006 Sep;21(9):1343-9. doi: 10.1002/mds.20974.
The aim of this study was to establish the rate of progression from mild cognitive impairment (MCI) to dementia in patients with Parkinson's disease (PD). PD patients without dementia were recruited in 1997 from an ongoing prospective epidemiological study. The assessment included neurological and psychiatric examinations, a clinical interview based on the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria for dementia, and a battery of neuropsychological tests. PD was diagnosed according to established criteria, dementia was diagnosed according to the DSM-III-R criteria, and subtypes of MCI were classified according to modified Petersen's criteria. Seventy-two nondemented PD patients were included. A total of 34 were cognitively intact, whereas 38 were diagnosed with MCI (amnestic, n = 6; single nonmemory domain, n = 17; multiple domains slightly impaired, n = 15). Fifty-nine patients (82%) completed follow-up examination 4 years later, and 18 (62%) of the patients with MCI and 6 (20%) of the cognitively intact PD patients were demented (P = 0.001). Single domain nonmemory MCI and multiple domains slightly impaired MCI were associated with later development of dementia (P = 0.003; P = 0.04), whereas amnestic MCI subtype was not (P = 0.76). We conclude that patients with PD and MCI had a higher risk of developing dementia than cognitively intact PD patients, suggesting that MCI in PD is an early manifestation of dementia. However, these findings should be interpreted with caution due to the relatively small number of subjects included in this study.
本研究的目的是确定帕金森病（PD）患者从轻度认知障碍（MCI）进展为痴呆的发生率。1997年，从一项正在进行的前瞻性流行病学研究中招募了无痴呆的PD患者。评估包括神经学和精神科检查、基于《精神障碍诊断与统计手册》第三版修订本（DSM-III-R）痴呆标准的临床访谈以及一系列神经心理学测试。PD根据既定标准进行诊断，痴呆根据DSM-III-R标准进行诊断，MCI亚型根据改良的彼得森标准进行分类。纳入了72例无痴呆的PD患者。其中34例认知功能正常，38例被诊断为MCI（遗忘型，n = 6；单一非记忆领域型，n = 17；多领域轻度受损型，n = 15）。4年后，59例患者（82%）完成了随访检查，MCI患者中有18例（62%）以及认知功能正常的PD患者中有6例（20%）出现痴呆（P = 0.001）。单一领域非记忆型MCI和多领域轻度受损型MCI与痴呆的后期发生相关（P = 0.003；P = 0.04），而遗忘型MCI亚型则不然（P = 0.76）。我们得出结论，与认知功能正常的PD患者相比，患有PD和MCI的患者发生痴呆的风险更高，这表明PD中的MCI是痴呆的早期表现。然而，由于本研究纳入的受试者数量相对较少，这些发现应谨慎解读。
