Department of Neurology, University of Southern California, Los Angeles, California.
Psychology Service, Veterans Administration San Diego Healthcare System (VA/SDHS), San Diego, California.
Int J Geriatr Psychiatry. 2020 Apr;35(4):396-404. doi: 10.1002/gps.5255. Epub 2020 Jan 23.
Mild cognitive impairment (MCI) and psychiatric symptoms (anxiety, depression, and apathy) are common in Parkinson's disease (PD). While studies have supported the association between psychiatric symptoms and cognitive performance in PD, it is unclear if the magnitude of link between psychiatric symptoms and cognitive health is stronger by MCI status. The purpose of this study was to examine the association between cognitive performance and psychiatric symptoms in PD and whether MCI status moderates this association.
METHODS/DESIGN: Participants (N = 187) completed a comprehensive neuropsychological assessment that included measures of attention, language, executive function (EF), visuospatial ability, episodic memory, and psychiatric symptoms. Participants were classified as PD-MCI (N = 73) or PD-normal cognition (NC; N = 114). Linear regression analyses were conducted to examine the association between psychiatric symptoms and cognitive performance and the moderating effect of PD-MCI status.
There were no differences in mean psychiatric symptoms between PD-MCI and PD-NC. Psychiatric symptoms were predominantly associated with worse EF. The magnitude of the association between anxiety and worse EF was larger in participants with PD-MCI compared with PD-NC. A multivariable regression analysis examining the independent contributions of each symptom demonstrated the most robust association between EF and anxiety.
Symptoms of anxiety, depression, and apathy are associated with worse executive functioning in individuals with PD. PD-MCI may be important in moderating the association between cognitive performance, specifically anxiety, and EF. Factors that promote cognitive resilience may serve as key therapeutic modalities in managing neuropsychiatric symptoms in PD.
轻度认知障碍（MCI）和精神症状（焦虑、抑郁和淡漠）在帕金森病（PD）中很常见。虽然研究支持 PD 中精神症状与认知表现之间的关联，但尚不清楚 MCI 状态是否会增强精神症状与认知健康之间的关联程度。本研究旨在探讨 PD 中认知表现与精神症状之间的关系，以及 MCI 状态是否调节这种关系。
方法/设计：参与者（N=187）完成了一项全面的神经心理学评估，包括注意力、语言、执行功能（EF）、视空间能力、情景记忆和精神症状的测量。参与者分为 PD-MCI（N=73）或 PD-正常认知（NC；N=114）。线性回归分析用于检验精神症状与认知表现之间的关系，以及 PD-MCI 状态的调节作用。
PD-MCI 和 PD-NC 之间的平均精神症状没有差异。精神症状主要与较差的 EF 相关。在 PD-MCI 参与者中，焦虑与较差的 EF 之间的关联程度大于 PD-NC 参与者。一项多变量回归分析检验了每个症状的独立贡献，结果表明焦虑与 EF 之间的关联最强。
焦虑、抑郁和淡漠的症状与 PD 个体的执行功能下降有关。PD-MCI 可能在调节认知表现（特别是焦虑和 EF）与 EF 之间的关系方面起着重要作用。促进认知弹性的因素可能是管理 PD 中神经精神症状的关键治疗模式。
