Neuroscience and Mental Health Institute,University of Alberta,Edmonton,Canada.
Department of Psychiatry,University of Alberta,Edmonton,Canada.
Int Psychogeriatr. 2018 Feb;30(2):253-260. doi: 10.1017/S1041610217002265. Epub 2017 Nov 2.
We apply recently recommended Parkinson's disease mild cognitive impairment (PD-MCI) classification criteria from the movement disorders society (MDS) to PD patients and controls and compare diagnoses to that of short global cognitive scales at baseline and over time. We also examine baseline prevalence of neuropsychiatric symptoms across different definitions of MCI.
51 PD patients and 50 controls were classified as cognitively normal, MCI, or demented using MDS criteria (1.5 or 2.0 SD below normative values), Clinical Dementia Rating Scale (CDR), and the Dementia Rating Scale (DRS). All subject had parallel assessment with the Neuropsychiatric inventory (NPI).
We confirmed that PD-MCI (a) is frequent, (b) increases the risk of PDD, and (c) affects multiple cognitive domains. We highlight the predictive variability of different criteria, suggesting the need for further refinement and standardization. When a common dementia outcome was used, the Level II MDS optimal testing battery with impairment defined as two SD below norms in 2+ tests performs the best. Neuropsychiatric symptoms were more common in PD across all baseline and longitudinal cognitive classifications.
Our results advance previous findings on the utility of MDS PD-MCI criteria for PD patients and controls at baseline and over time. Additionally, we emphasize the possible utility of other cognitive scales and neuropsychiatric symptoms.
我们应用运动障碍协会(MDS)最近推荐的帕金森病轻度认知障碍(PD-MCI)分类标准,对 PD 患者和对照组进行分类,并将诊断结果与基线和随时间推移的简短全面认知量表进行比较。我们还检查了不同 MCI 定义下神经精神症状的基线患病率。
使用 MDS 标准(低于正常参考值 1.5 或 2.0 个标准差)、临床痴呆评定量表(CDR)和痴呆评定量表(DRS),将 51 名 PD 患者和 50 名对照组分类为认知正常、MCI 或痴呆。所有患者均接受神经精神疾病问卷(NPI)的平行评估。
我们证实 PD-MCI (a)很常见,(b)增加 PDD 的风险,(c)影响多个认知领域。我们强调了不同标准的预测变异性,提示需要进一步细化和标准化。当使用共同的痴呆结局时,MDS 二级最佳测试组合,其定义为两个以上测试中低于正常值 2 个标准差的损害,表现最佳。在所有基线和纵向认知分类中,PD 患者的神经精神症状更为常见。
我们的研究结果进一步证实了 MDS PD-MCI 标准在 PD 患者和对照组基线和随时间推移的有效性。此外,我们强调了其他认知量表和神经精神症状的可能效用。