Klepac N, Trkulja V, Relja M, Babić T
Department of Neurology, University Clinical Hospital Center Zagreb, Zagreb University School of Medicine, Zagreb, Croatia.
Eur J Neurol. 2008 Feb;15(2):128-33. doi: 10.1111/j.1468-1331.2007.02011.x.
Whilst the association between dementia and poorer health-related quality of life (Hr-QoL) in Parkinson's disease (PD) has been well established, we aimed to explore the relationship between cognitive performance and Hr-QoL in PD without dementia. Consecutive PD patients (n = 124, 54% men, age 60.4 +/- 10.3 years) judged as non-demented based on DSM-IV criteria and Mini Mental State Examination, free of other neurodegenerative diseases or psychotic difficulties and antipsychotic/antidepressive/anxyolitic treatment were assessed in a battery of neuropsychological tests. We used Parkinson's disease questionnaire (PDQ-39) to asses Hr-QoL and Beck's Depression Inventory (BDI) to quantify depression. In the univariate analysis, better performance in each of the tests evaluating visual attention/memory or visuospatial and executive functions was associated with better Hr-QoL. In multivariate analysis [adjustment for BDI score, PD severity and duration, l-dopa dose, age, sex, education, employment status and early PD onset (<50 years of age)] in which these tests were either represented by a common variable identified in a principal components analysis or were considered individually, better cognitive performance was independently associated with better Hr-QoL. The association was conditional on the level of depression, i.e., apparent only in patients with low(er) BDI scores. Cognitive performance appears associated with Hr-QoL even in non-demented PD patients.
虽然帕金森病（PD）中痴呆与较差的健康相关生活质量（Hr-QoL）之间的关联已得到充分证实，但我们旨在探讨无痴呆的PD患者认知表现与Hr-QoL之间的关系。根据DSM-IV标准和简易精神状态检查表判断为非痴呆的连续PD患者（n = 124，54%为男性，年龄60.4±10.3岁），无其他神经退行性疾病或精神障碍，且未接受抗精神病药/抗抑郁药/抗焦虑药治疗，接受了一系列神经心理学测试。我们使用帕金森病问卷（PDQ-39）评估Hr-QoL，并使用贝克抑郁量表（BDI）量化抑郁程度。在单变量分析中，评估视觉注意力/记忆力或视觉空间和执行功能的每项测试中表现越好，与越好的Hr-QoL相关。在多变量分析中[对BDI评分、PD严重程度和病程、左旋多巴剂量、年龄、性别、教育程度、就业状况和早期PD发病（<50岁）进行校正]，这些测试要么由主成分分析中确定的一个共同变量表示，要么单独考虑，较好的认知表现与较好的Hr-QoL独立相关。这种关联取决于抑郁程度，即仅在BDI评分较低的患者中明显。即使在无痴呆的PD患者中，认知表现似乎也与Hr-QoL相关。
