Ishii Nobuyuki, Mochizuki Hitoshi, Sakai Katsuya, Ogawa Go, Shiomi Kazutaka, Nakazato Masamitsu
Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan.
Dement Geriatr Cogn Dis Extra. 2019 Sep 10;9(3):338-343. doi: 10.1159/000502351. eCollection 2019 Sep-Dec.
Polypharmacy is well known to affect cognitive function in community-dwelling older adults. However, the effect of polypharmacy on cognitive function in patients with newly diagnosed Parkinson's disease remains unknown. Here, we evaluated the association between polypharmacy and cognitive function in patients with newly diagnosed Parkinson's disease.
This cross-sectional study enrolled 131 consecutive hospitalized patients with newly diagnosed Parkinson's disease. Cognitive function was evaluated with the Mini-Mental State Examination and analyzed between groups of patients with or without polypharmacy. Comparisons were adjusted for confounders by performing inverse probability weighting with propensity scores.
After inverse probability weighting, patients in the polypharmacy group had a significantly lower Mini-Mental State Examination score than patients in the nonpolypharmacy group (26.2 vs. 27.7, = 0.001).
Polypharmacy was associated with cognitive decline in patients with newly diagnosed Parkinson's disease. This finding suggests that medication reduction might serve as a promising intervention to prevent the development of dementia in patients with early Parkinson's disease. Further prospective studies are needed to determine whether medication reduction improves cognitive function in patients with newly diagnosed Parkinson's disease.
众所周知，多重用药会影响社区居住的老年人的认知功能。然而，多重用药对新诊断帕金森病患者认知功能的影响尚不清楚。在此，我们评估了新诊断帕金森病患者多重用药与认知功能之间的关联。
这项横断面研究纳入了131例连续住院的新诊断帕金森病患者。使用简易精神状态检查表评估认知功能，并在有或没有多重用药的患者组之间进行分析。通过倾向评分进行逆概率加权来调整混杂因素。
经过逆概率加权后，多重用药组患者的简易精神状态检查表得分显著低于非多重用药组患者（26.2对27.7，P = 0.001）。
多重用药与新诊断帕金森病患者的认知衰退有关。这一发现表明，减少用药可能是预防早期帕金森病患者痴呆症发展的一种有前景的干预措施。需要进一步的前瞻性研究来确定减少用药是否能改善新诊断帕金森病患者的认知功能。
