Lee Su Yun, Ryu Hyun Ju, Seo Jeong Wook, Noh Maeng Seok, Cheon Sang Myung, Kim Jae Woo
Department of Neurology, Parkinson's Disease Center, College of Medicine, Dong-A University, Busan, Korea.
Department of Preventive Medicine, College of Medicine, Dong-A University, Busan, Korea.
J Clin Neurol. 2017 Jan;13(1):21-26. doi: 10.3988/jcn.2017.13.1.21. Epub 2016 Oct 7.
Few studies of dementia in Parkinson's disease (PD) have had long-term follow-ups. Moreover, information on the duration from the onset to the development of dementia in patients with PD is lacking. The aim of this study was to determine the median dementia-free survival time from the onset of PD to the development of dementia.
In total, 1,193 Korean patients with PD were recruited and assessed at regular intervals of 3-6 months. We interviewed the patients and other informants to identify impairments in the activities of daily living. The Hoehn and Yahr stage and scores on the Unified Parkinson's Disease Rating Scale and Mini Mental State Examination were evaluated annually. We used Kaplan-Meier survival analysis to estimate the cumulative proportion of dementia-free patients over time. Risk factors predicting dementia were also evaluated using Cox proportional-hazards regression models.
The median dementia-free survival time in the Korean PD population was 19.9 years. Among the 119 patients who subsequently developed dementia, the mean duration from the onset of PD to the development of dementia was 10.6 years. A multivariate analysis identified age at onset and education period as the significant predictors of dementia.
This is the first report on dementia-free survival in patients with PD based on longitudinal data analysis from the disease onset. The median dementia-free survival time in Korean PD patients was found to be longer than expected.
帕金森病（PD）痴呆的研究很少有长期随访。此外，缺乏关于PD患者从发病到痴呆发生的持续时间的信息。本研究的目的是确定从PD发病到痴呆发生的无痴呆生存时间中位数。
共招募了1193例韩国PD患者，并每隔3 - 6个月进行定期评估。我们对患者和其他信息提供者进行访谈，以确定日常生活活动中的损伤情况。每年评估Hoehn和Yahr分期以及统一帕金森病评定量表和简易精神状态检查表的评分。我们使用Kaplan-Meier生存分析来估计随时间无痴呆患者的累积比例。还使用Cox比例风险回归模型评估预测痴呆的危险因素。
韩国PD人群的无痴呆生存时间中位数为19.9年。在随后发生痴呆的119例患者中，从PD发病到痴呆发生的平均持续时间为10.6年。多因素分析确定发病年龄和受教育年限是痴呆的重要预测因素。
这是基于从疾病发病开始的纵向数据分析得出的关于PD患者无痴呆生存的首次报告。发现韩国PD患者的无痴呆生存时间中位数比预期的要长。
