Neurology and Movement Disorders Unit, EA2683, Faculty of Medicine and University Medical Center, Lille, France.
J Neurol. 2010 Jan;257(1):79-84. doi: 10.1007/s00415-009-5268-2. Epub 2009 Aug 19.
Cognitive complaint interviews (CCI) have been shown to be useful in the early detection of dementia in elderly people. Surprisingly, CCIs are rarely used in Parkinson's disease (PD), despite a six-fold higher risk of dementia than in healthy subjects. The present study sought to determine whether a structured CCI could detect cognitive decline in PD. A validated CCI was added to the usual clinical interview for 180 PD patients. Objective cognitive status was assessed by the Mattis dementia rating scale score. The CCIs ability to detect cognitive decline in PD patients was determined using a receiver operating characteristic (ROC) curve. 58 (32.22%) patients had a significant, subjective cognitive complaint (CCI score >3). Of these, 48.27% had objective cognitive decline. Objective cognitive decline was significantly more frequent in the patients with subjective cognitive complaint. However, the ROC curve for discriminating between patients with and without objective cognitive deficits as a function of their subjective cognitive complaint had low sensitivity (0.50, 95% CI: 0.36-0.64) and moderate specificity (0.74, 95% CI: 0.69-0.84). Logistic regression incorporating the main demographical and clinical variables showed that the CCI score's discriminant power was improved by adding age and the number of years in education to the predictive model. Objective cognitive decline and dementia are more frequent among PD patients reporting a cognitive complaint than among patients not reporting a complaint. However, the CCI does not enable more accurate screening for PD-associated dementia.
认知主诉访谈（CCI）已被证明可用于早期发现老年人痴呆症。令人惊讶的是，CCI 在帕金森病（PD）中很少使用，尽管 PD 患者痴呆症的风险比健康受试者高六倍。本研究旨在确定结构化 CCI 是否可以检测 PD 中的认知下降。在 180 名 PD 患者的常规临床访谈中增加了经过验证的 CCI。通过 Mattis 痴呆评定量表评分评估客观认知状态。使用受试者工作特征（ROC）曲线确定 CCI 在 PD 患者中检测认知下降的能力。58 名（32.22%）患者有明显的主观认知主诉（CCI 评分>3）。其中，48.27%有客观认知下降。有主观认知主诉的患者客观认知下降明显更为频繁。然而，ROC 曲线区分有和无客观认知缺陷的患者作为其主观认知主诉的函数，灵敏度低（0.50，95%CI：0.36-0.64），特异性中等（0.74，95%CI：0.69-0.84）。纳入主要人口统计学和临床变量的逻辑回归表明，CCI 评分的判别能力通过向预测模型中添加年龄和受教育年限得到改善。报告认知主诉的 PD 患者比未报告主诉的患者客观认知下降和痴呆更为常见。然而，CCI 并不能更准确地筛查 PD 相关痴呆症。
