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帕金森病诊断时体重指数对认知功能衰退的影响

The Influence of Body Mass Index at Diagnosis on Cognitive Decline in Parkinson's Disease.

作者信息

Yoo Han Soo, Chung Seok Jong, Lee Phil Hyu, Sohn Young H, Kang Suk Yun

机构信息

Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.

出版信息

J Clin Neurol. 2019 Oct;15(4):517-526. doi: 10.3988/jcn.2019.15.4.517.

DOI:10.3988/jcn.2019.15.4.517
PMID:31591841
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6785479/
Abstract

BACKGROUND AND PURPOSE

Associations between alterations in body mass index (BMI) and cognitive function have been reported in Parkinson's disease (PD). We investigated whether the BMI at a PD diagnosis is associated with cognitive decline and the future development of dementia.

METHODS

We recruited 70 patients with PD who underwent neuropsychological testing every 3 years and were followed up for more than 6 years. We classified patients into the following three groups based on their BMI at the diagnosis: under-/normal weight (=21), overweight (=22), and obese (=27). We evaluated differences in the rate of cognitive decline over time among the groups using linear mixed models and the conversion rate to dementia using survival analysis.

RESULTS

The obese patients with PD showed a slower deterioration of global cognitive function as well as language and memory functions than did the under-/normal-weight group during the 6-year follow-up. The three BMI groups showed different rates of conversion to dementia (log-rank test: =0.026). The combined overweight and obese group showed a lower risk of developing dementia compared with the under-/normal-weight group (hazard ratio= 0.36, 95% CI=0.12-0.82, =0.046).

CONCLUSIONS

We have demonstrated that a higher-than-normal BMI at the time of a PD diagnosis has a protective effect against the deterioration of cognitive function and the conversion to dementia.

摘要

背景与目的

帕金森病(PD)患者的体重指数(BMI)变化与认知功能之间的关联已有报道。我们研究了PD诊断时的BMI是否与认知功能下降及未来痴呆的发生有关。

方法

我们招募了70例PD患者,他们每3年接受一次神经心理学测试,并随访超过6年。根据诊断时的BMI将患者分为以下三组:体重过轻/正常体重(=21)、超重(=22)和肥胖(=27)。我们使用线性混合模型评估各组随时间的认知功能下降率差异,并使用生存分析评估痴呆转化率。

结果

在6年的随访中,PD肥胖患者的整体认知功能以及语言和记忆功能的恶化速度比体重过轻/正常体重组慢。三个BMI组的痴呆转化率不同(对数秩检验:=0.026)。与体重过轻/正常体重组相比,超重和肥胖合并组患痴呆的风险较低(风险比=0.36,95%置信区间=0.12-0.82,=0.046)。

结论

我们证明,PD诊断时高于正常的BMI对认知功能恶化和痴呆转化具有保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a6/6785479/a8f06af7b5b1/jcn-15-517-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a6/6785479/dac992ff1a91/jcn-15-517-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a6/6785479/efdb30842d81/jcn-15-517-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a6/6785479/a8f06af7b5b1/jcn-15-517-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a6/6785479/dac992ff1a91/jcn-15-517-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a6/6785479/efdb30842d81/jcn-15-517-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a6/6785479/a8f06af7b5b1/jcn-15-517-g003.jpg

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