Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, 101 South Newell Drive, Gainesville, FL 32601, USA ; Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida, 3450 Hull Road Gainesville, FL 32607, USA.
Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida, 3450 Hull Road Gainesville, FL 32607, USA.
Parkinsons Dis. 2014;2014:507529. doi: 10.1155/2014/507529. Epub 2014 Jan 23.
Objective. Health comorbidities, particularly cardiovascular risk factors, are well known to pose risks for cognitive decline in older adults. To date, little attention has focused on the impact of these comorbidities on Parkinson's disease (PD). This study examined the prevalence and contribution of comorbidities on cognitive status in PD patients, above and beyond the effects of disease severity. Methods. A cross sectional design was used, including neuropsychological data on 341 PD patients without severe cognitive decline. Comorbidity data were collected via medical chart review. Data were analyzed using a series of multiple hierarchical regressions, controlling for PD-related disease variables. Results. Overall sample characteristics are 69% male, disease duration 9.7 years, Unified Parkinson's Disease Rating Scale 26.4, and age 64.7 years. Hypercholesterolemia (41.6%), hypertension (38.1%), and hypotension (30.2%) were the most reported comorbidities. The presence of hypertension significantly contributed to domains of executive function and verbal memory. The cooccurrence of orthostatic hypotension moderated the relationship between hypertension and executive function. Conclusions. This study on a large cohort of PD patients provides evidence for a detrimental influence of health comorbidities, particularly hypertension, on cognitive domains that have traditionally been conceptualized as being frontally and/or temporally mediated.
目的。众所周知,健康合并症,特别是心血管危险因素,会给老年人的认知能力下降带来风险。迄今为止,人们对这些合并症对帕金森病(PD)的影响关注甚少。本研究考察了在 PD 患者中,除了疾病严重程度的影响外,这些合并症对认知状态的患病率和贡献。
方法。采用横断面设计,包括 341 名无严重认知能力下降的 PD 患者的神经心理学数据。通过病历回顾收集合并症数据。使用一系列多元分层回归分析,控制与 PD 相关的疾病变量,对数据进行分析。
结果。总体样本特征为男性占 69%,疾病持续时间为 9.7 年,统一帕金森病评定量表(Unified Parkinson's Disease Rating Scale)为 26.4,年龄为 64.7 岁。报告最多的合并症是高胆固醇血症(41.6%)、高血压(38.1%)和低血压(30.2%)。高血压的存在显著影响执行功能和言语记忆领域。直立性低血压的共病会调节高血压与执行功能之间的关系。
结论。本研究对一大群 PD 患者进行了研究,为健康合并症(特别是高血压)对传统上被认为与额叶和/或颞叶有关的认知领域产生不利影响提供了证据。