Arch Clin Neuropsychol. 2022 Jan 17;37(1):1-11. doi: 10.1093/arclin/acab037.
Rapid Eye Movement Sleep Behavior Disorder (RBD) is common in Parkinson's Disease (PD) and is associated with cognitive impairment; however, the majority of the evidence on the impact of RBD on multidomain cognitive batteries in PD is cross-sectional. This study evaluated the longitudinal impact of probable RBD (pRBD) on cognitive, psychiatric, and functional outcomes in people with PD.
Case-control study. A total of 65 people with PD completed the study protocol at baseline and 16-to-47-month follow-up. Participants were classified as pRBD+ (n = 25) or pRBD- (n = 40) based on an established cutoff of 6 on the RBD Sleep Questionnaire (RBDSQ). Participants also completed a) comprehensive cognitive testing, b) self-report measures of depression, anxiety, and apathy, and c) performance-based and other-report forms of instrumental activities of daily living.
Baseline mean age was 67.8 (SD = 8.1; range = 45-86) and baseline mean years of education was 16.4 (SD = 2.1; range = 12-20). The two groups did not differ on measured demographic characteristics. Baseline mean T-scores for cognitive tests were in the average range (46-55). Hierarchical linear models tested group differences in cognitive and functional decline from baseline to follow-up, controlling for appropriate demographic and psychiatric variables. Compared to the pRBD- group, pRBD+ participants showed greater decline in attention/working memory (r = -0.31; p = 0.01) and UPSA financial skills (r = -0.31; p = 0.01). No other group differences approached significance.
RBD may differentially affect attention/working memory and financial abilities in PD. Results underscore the importance of regular RBD screening in older adults with PD in order to triage symptomatic patients to appropriate cognitive and medical interventions.
快速眼动睡眠行为障碍（RBD）在帕金森病（PD）中很常见，并且与认知障碍有关；然而，关于 RBD 对 PD 多领域认知电池的影响的大多数证据都是横断面的。本研究评估了可能的 RBD（pRBD）对 PD 患者认知、精神和功能结果的纵向影响。
病例对照研究。共有 65 名 PD 患者在基线和 16 至 47 个月的随访时完成了研究方案。根据 RBD 睡眠问卷（RBDSQ）的 6 分确定的截断值，参与者被分为 pRBD+（n=25）或 pRBD-（n=40）。参与者还完成了 a）全面认知测试、b）抑郁、焦虑和冷漠的自我报告测量，以及 c）基于表现和其他报告形式的日常生活活动的工具。
基线时的平均年龄为 67.8（SD=8.1；范围=45-86），平均受教育年限为 16.4（SD=2.1；范围=12-20）。两组在测量的人口统计学特征上没有差异。基线时认知测试的平均 T 分数在平均范围内（46-55）。分层线性模型测试了从基线到随访的认知和功能下降的组间差异，控制了适当的人口统计学和精神变量。与 pRBD-组相比，pRBD+参与者在注意力/工作记忆（r=-0.31；p=0.01）和 UPSA 财务技能（r=-0.31；p=0.01）方面的下降更为明显。其他组间差异没有达到显著水平。
RBD 可能在 PD 中对注意力/工作记忆和财务能力产生不同的影响。结果强调了在老年 PD 患者中定期进行 RBD 筛查的重要性，以便对有症状的患者进行分类，以进行适当的认知和医疗干预。
