Muslimović Dino, Schmand Ben, Speelman Johannes D, de Haan Rob J
Department of Neurology, Academic Medical Centre, University of Amsterdam, The Netherlands.
J Int Neuropsychol Soc. 2007 Nov;13(6):920-32. doi: 10.1017/S1355617707071160.
A meta-analysis was conducted on 25 longitudinal studies involving 901 initially non-demented Parkinson's disease (PD) patients to examine the magnitude of decline across multiple cognitive domains associated with disease progression. Pooled effect sizes reflecting the standardized difference between baseline and follow-up neuropsychological performance were calculated for 8 cognitive domains using a random-effects model. Relatively small effect sizes were found across all cognitive domains (d = .00 - .40). During a mean follow-up interval of 29 months, significant declines were detected in global cognitive ability (d = .40), visuoconstructive skills (d = .32), and memory (d = .29). Age showed a significant relation with decline in global cognitive ability and memory. Lower educational level was associated with greater decline in all cognitive domains. Studies with longer follow-up intervals yielded larger effect sizes for global cognitive ability. In non-demented PD patients, changes in cognitive functions over time appear to be modest. Educational level, age, and length of the follow-up interval are likely to affect the magnitude of decline in several domains. Methodological flaws, such as selection bias and uncontrolled practice effects, may have caused underestimation of the true extent of decline.
对25项纵向研究进行了荟萃分析，这些研究涉及901名最初无痴呆的帕金森病（PD）患者，以检验与疾病进展相关的多个认知领域的衰退程度。使用随机效应模型计算了8个认知领域反映基线与随访神经心理学表现标准化差异的合并效应量。在所有认知领域均发现相对较小的效应量（d = 0.00 - 0.40）。在平均29个月的随访期内，发现整体认知能力（d = 0.40）、视觉构建技能（d = 0.32）和记忆力（d = 0.29）有显著下降。年龄与整体认知能力和记忆力的下降存在显著关系。较低的教育水平与所有认知领域更大程度的衰退相关。随访间隔较长的研究在整体认知能力方面产生了更大的效应量。在无痴呆的PD患者中，认知功能随时间的变化似乎较小。教育水平、年龄和随访间隔时间可能会影响多个领域的衰退程度。方法学缺陷，如选择偏倚和未控制的练习效应，可能导致对衰退真实程度的低估。
