Department of Psychology at the University of Kansas, Lawrence, Kans., USA.
Dement Geriatr Cogn Disord. 2011;31(2):98-108. doi: 10.1159/000323570. Epub 2011 Jan 18.
The longitudinal cognitive course in Parkinson's disease (PD) with and without dementia remains undefined. We compared cross-sectional models of cognition in PD (both with and without dementia), Alzheimer's disease (AD), and nondemented aging and followed the participants over time.
Previously validated models of cognitive performance in AD and nondemented aging were extended to individuals with PD (with dementia, n = 71; without dementia, n = 47). Confirmatory factor analysis and piecewise regression were used to compare the longitudinal course of participants with PD with 191 cognitively healthy subjects and 115 individuals with autopsy-confirmed AD.
A factor analytic model with one general factor and three specific factors (verbal memory, visuospatial memory, working memory) fit demented and nondemented PD. Longitudinal change indicated that individuals with PD with dementia declined significantly more rapidly on visuospatial and verbal memory tasks than AD alone. Cognitive declines across all factors in AD and PD dementia accelerated several years prior to clinical dementia diagnosis.
Both specific and global cognitive changes are witnessed in PD and AD. Longitudinal profiles of cognitive decline in PD and AD differed. PD with or without dementia has a core feature of longitudinal decline in visuospatial abilities.
帕金森病（PD）伴或不伴痴呆的纵向认知过程仍未确定。我们比较了 PD（伴或不伴痴呆）、阿尔茨海默病（AD）和认知正常老化患者的横断面认知模型，并对参与者进行了随访。
将 AD 和认知正常老化患者中经过验证的认知表现模型扩展到 PD 患者（伴痴呆，n = 71；不伴痴呆，n = 47）。采用验证性因子分析和分段回归比较了 PD 患者的纵向病程，共纳入 191 名认知健康受试者和 115 名经尸检证实的 AD 患者。
具有一个一般因素和三个特定因素（言语记忆、视空间记忆、工作记忆）的因子分析模型适用于痴呆和非痴呆 PD。纵向变化表明，与 AD 相比，痴呆 PD 患者在视空间和言语记忆任务上的下降速度明显更快。AD 和 PD 痴呆症患者的所有因素的认知下降在临床痴呆诊断前几年就加速了。
PD 和 AD 均可见到特定和整体认知变化。AD 和 PD 痴呆症的纵向认知衰退模式不同。PD 伴或不伴痴呆具有纵向视空间能力下降的核心特征。
