Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, US.
Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, US.
Tremor Other Hyperkinet Mov (N Y). 2021 May 11;11:16. doi: 10.5334/tohm.624.
Patients with essential tremor (ET) have an increased risk of cognitive impairment, yet little is known about the predictors of cognitive decline in these patients. Exposures to infectious agents throughout the lifespan may impact the later development of cognitive impairment. For example, high Infection exposure has been associated with lower cognitive performance in Alzheimer's and Parkinson's disease. However, this predictor has not been examined in ET.
To determine whether a higher baseline infection burden is associated with worse cognitive performance at baseline and greater cognitive decline over time in an ET cohort.
METHOD/DESIGN: 160 elderly non-demented ET participants (80.0 ± 9.5 years) underwent an extensive cognitive evaluation at three time points. At baseline, participants completed an infection burden questionnaire (t-IBQ) that elicited information on previous exposure to infectious agents and number of episodes per disease. Analysis of covariance and generalized estimated equations (GEEs) were used.
Overall, infection burden was not associated baseline cognitive performance. Adjusted GEE models for repeated measures yielded a significant time interaction between moderate infection burden at baseline and better performance in the attention domain over time ( = 0.013). Previous history of rubella was associated with faster rate of decline in visuospatial performance ( = 0.046).
The data were mixed. Moderate self-reported infection burden was associated with better attention performance over time. Self-reported history of rubella infection was related to lower visuospatial performance over time in this cohort. Follow-up studies with additional design elements would be of value.
特发性震颤（ET）患者认知障碍的风险增加，但对于这些患者认知下降的预测因素知之甚少。一生中接触感染因子可能会影响认知障碍的后期发展。例如，高感染暴露与阿尔茨海默病和帕金森病的认知表现降低有关。然而，这一预测因子尚未在 ET 中进行研究。
确定基线感染负担较高是否与 ET 队列的基线认知表现较差和随时间推移认知下降较快相关。
方法/设计：160 名老年非痴呆 ET 参与者（80.0 ± 9.5 岁）在三个时间点接受了广泛的认知评估。在基线时，参与者完成了感染负担问卷（t-IBQ），该问卷询问了他们以前接触感染因子的情况和每种疾病的发作次数。采用协方差分析和广义估计方程（GEE）进行分析。
总体而言，感染负担与基线认知表现无关。重复测量的调整 GEE 模型显示，基线时中度感染负担与注意力域随时间改善之间存在显著的时间交互作用（ = 0.013）。风疹既往史与视空间表现下降速度加快有关（ = 0.046）。
数据喜忧参半。中度自我报告的感染负担与注意力表现随时间改善相关。本队列中，自我报告的风疹感染史与随时间推移的视空间表现下降有关。具有额外设计元素的后续研究将具有价值。
