Cammisuli Davide M, Crowe Simon
Department of Surgical, Medical, Molecular and Critical Area Pathology, Pisa University Medical School, Pisa, Italy,
School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
Neuropsychiatr Dis Treat. 2018 Oct 2;14:2531-2539. doi: 10.2147/NDT.S173820. eCollection 2018.
Patients with Parkinson's disease (PD) present with a wide range of cognitive deficits. Cognitive impairment is recognized as an independent nonmotor aspect of the disorder and has a critical role in functional outcome and conversion into PD dementia. To date, everyday memory impairment in elderly patients with PD is underinvestigated and its relationship with executive dysfunction was not clearly explained. Our study aims at clarifying the neuropsychological pattern of everyday memory and executive deterioration in elderly patients with PD.
Forty nondemented PD patients (mean age 71.2 years; M:F = 29:11) and 30 well-matched controls (mean age 70.7 years; M:F = 15:15) were assessed on everyday memory (Rivermead Behavioral Memory Test [RBMT]) and executive functioning (Frontal Assessment Battery [FAB]) measures. Mann-Whitney -tests (Bonferroni corrected) were used to compare groups on these measures and Spearman's rank correlations were performed to highlight their associations.
PD patients performed worse than controls on recall for novel tasks and geographic recall (RMBT) as well as lexical fluency and mental flexibility (FAB). Particularly, spatial orientation depending on egocentric navigation seems to be altered in PD patients. The clinical group showed poorer performances than controls in mental flexibility, sensitivity to interference, and inhibitory control. Such measures were associated with immediate and delayed recall, picture recognition, prospective memory, and orientation tasks of everyday memory.
Executive-type difficulties and memory-type difficulties have an impact on cognitive performances of elderly patients with PD. We recommend using the RBMT and the FAB as part of routinely neuropsychological battery for assessing PD patients.
帕金森病（PD）患者存在广泛的认知缺陷。认知障碍被认为是该疾病独立的非运动方面，并且在功能结局以及向帕金森病痴呆的转变中起关键作用。迄今为止，老年PD患者的日常记忆损害研究不足，其与执行功能障碍的关系也未得到明确解释。我们的研究旨在阐明老年PD患者日常记忆和执行功能衰退的神经心理学模式。
对40名非痴呆的PD患者（平均年龄71.2岁；男∶女 = 29∶11）和30名匹配良好的对照组（平均年龄70.7岁；男∶女 = 15∶15）进行日常记忆（里弗米德行为记忆测试[RBMT]）和执行功能（额叶评估量表[FAB]）测量。使用曼-惠特尼检验（经邦费罗尼校正）比较两组在这些测量上的差异，并进行斯皮尔曼等级相关分析以突出它们之间的关联。
在新任务回忆和地理回忆（RBMT）以及词汇流畅性和心理灵活性（FAB）方面，PD患者的表现比对照组差。特别是，依赖自我中心导航的空间定向在PD患者中似乎发生了改变。临床组在心理灵活性、对干扰的敏感性和抑制控制方面的表现比对照组差。这些测量与日常记忆的即时和延迟回忆、图片识别、前瞻性记忆及定向任务相关。
执行功能型困难和记忆型困难对老年PD患者的认知表现有影响。我们建议将RBMT和FAB作为评估PD患者常规神经心理学测试组合的一部分。
