Lin Wei-Che, Huang Yu-Chi, Leong Chau-Peng, Chen Meng-Hsiang, Chen Hsiu-Ling, Tsai Nai-Wen, Tso Hui-Hsin, Chen Po-Cheng, Lu Cheng-Hsien
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Front Aging Neurosci. 2019 Oct 30;11:283. doi: 10.3389/fnagi.2019.00283. eCollection 2019.
: Parkinson's disease (PD) is a neurodegenerative disease manifested by both motor and non-motor dysfunctions and co-existence of cognitive impairment and physical frailty is common. Given that research in this area is limited, a better understanding of associated factors with physical frailty could provide a focused screening method and facilitate early intervention in PD. : Seventy-six patients with idiopathic PD were recruited and Fried's criteria of physical frailty were used to group all participants. Comprehensive cognitive tests and clinical characteristics were measured, and univariate and multivariate analysis was performed to explore the relationship between clinical factors or neuropsychological functions. : Twenty-nine patients with PD (38%) exhibited physical frailty. Compared to PD patients without frailty, PD patients with frailty were older in age and demonstrated worse disease severity and poorer cognitive functions, including attention, executive function, memory, speech and language, and visuospatial function ( < 0.05). Further, stepwise logistic regression analysis revealed that disease severity by the Unified Parkinson's Disease Rating Scale (UPDRS) total score (OR: 1.065; 95% CI: 1.033-1.099) and executive function (OR: 0.724; 95% CI: 0.581-0.877) were independent risk factors for predicting physical frailty ( = 0.003 and 0.002). The best cut-off points are 46 in UPDRS (sensitivity: 62.1%; specificity: 91.5%). : Executive function impairment is an independent risk factor for the development of physical frailty with disease progression. Awareness of such comorbidity might provide a screening tool to facilitate investigation in their underlying etiology and early intervention for frailty prevention.
帕金森病（PD）是一种神经退行性疾病，表现为运动和非运动功能障碍，认知障碍和身体虚弱并存的情况很常见。鉴于该领域的研究有限，更好地了解与身体虚弱相关的因素可以提供一种有针对性的筛查方法，并有助于对帕金森病进行早期干预。招募了76例特发性帕金森病患者，并采用弗里德身体虚弱标准对所有参与者进行分组。进行了综合认知测试和临床特征测量，并进行单因素和多因素分析以探讨临床因素或神经心理功能之间的关系。29例帕金森病患者（38%）表现出身体虚弱。与无身体虚弱的帕金森病患者相比，有身体虚弱的帕金森病患者年龄更大，疾病严重程度更差，认知功能更差，包括注意力、执行功能、记忆、言语和语言以及视觉空间功能（P<0.05）。此外，逐步逻辑回归分析显示，统一帕金森病评定量表（UPDRS）总分所衡量的疾病严重程度（OR：1.065；95%CI：1.033 - 1.099）和执行功能（OR：0.724；95%CI：0.581 - 0.877）是预测身体虚弱的独立危险因素（P = 0.003和0.002）。UPDRS的最佳截断点为46（敏感性：62.1%；特异性：91.5%）。执行功能障碍是疾病进展过程中身体虚弱发展的独立危险因素。认识到这种共病情况可能提供一种筛查工具，以促进对其潜在病因的调查和对虚弱预防的早期干预。
