Medical Psychology I Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Köln, Germany.
German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany.
J Parkinsons Dis. 2018;8(2):183-193. doi: 10.3233/JPD-181306.
Cognitive dysfunction is one of the most prevalent non-motor symptoms in Parkinson's disease (PD), often experienced as more debilitating for patients and caregivers than motor problems. Therefore, a deeper understanding of the course of cognitive decline and the identification of valid progression markers for Parkinson's disease dementia (PDD) is essential.
This systematic review summarizes the current state of knowledge on cognitive decline over time by reporting effect sizes of cognitive changes in neuropsychological tests.
1368 studies were identified by a PubMed database search and 25 studies by additionally scanning previous literature. After screening all records, including 69 full-text article reviews, 12 longitudinal studies on the progression of cognitive decline in PD met our criteria (e.g., sample size ≥50 patients).
Only a few studies monitored cognitive decline over a longer period (>4 years). Most studies focused on the evaluation of change in global cognitive state by use of the Mini-Mental State Examination, whereas the use of neuropsychological tests was highly heterogenic among studies. Only one study evaluated patients' cognitive performance in all specified domains (executive function, attention & working memory, memory, language, and visual-spatial function) allowing for diagnosis of cognitive impairment according to consensus guidelines. Medium to strong effect sizes could only be observed in studies with follow-up intervals of four years or longer.
The results emphasize the need for the assessment of larger PD cohorts over longer periods of follow-up with a comprehensive neuropsychological battery.
认知功能障碍是帕金森病（PD）中最常见的非运动症状之一，通常比运动问题对患者和护理人员的影响更为严重。因此，深入了解认知能力下降的过程并确定帕金森病痴呆（PDD）的有效进展标志物至关重要。
本系统综述通过报告神经心理学测试中认知变化的效应量，总结了随时间推移认知下降的当前知识状态。
通过 PubMed 数据库搜索确定了 1368 项研究，并通过额外扫描先前的文献确定了 25 项研究。在筛选了所有记录，包括 69 篇全文文章综述后，12 项关于 PD 认知下降进展的纵向研究符合我们的标准（例如，样本量≥50 名患者）。
只有少数研究监测了较长时间（>4 年）的认知下降。大多数研究专注于使用 Mini-Mental State Examination 评估整体认知状态的变化，而研究之间神经心理学测试的使用高度异质。只有一项研究评估了患者在所有指定领域（执行功能、注意力和工作记忆、记忆、语言和视觉空间功能）的认知表现，根据共识指南可以诊断为认知障碍。只有在随访间隔为四年或更长时间的研究中才能观察到中等到较大的效应量。
这些结果强调需要对更大的 PD 队列进行更长时间的随访评估，并使用全面的神经心理学测试。
