Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA.
Department of Neurology and Neurological Sciences, Stanford School of Medicine, Palo Alto, CA, USA.
J Clin Exp Neuropsychol. 2021 Jul;43(5):469-480. doi: 10.1080/13803395.2021.1927995. Epub 2021 Aug 6.
: Parkinson's disease (PD) is associated with a range of cognitive deficits. Few studies have carefully examined the subtle impacts of PD on cognition among patients who do not meet formal criteria for MCI or dementia. The aim of the current study was thus to describe the impact of PD on cognition in those without cognitive impairment in a well-characterized cohort.: Non-cognitively impaired participants (122 with PD, 122 age- and sex-matched healthy volunteers) underwent extensive cognitive testing. Linear regression analyses compared diagnostic group performance across cognitive measures. For cognitive tasks that were significantly different between groups, additional analyses examined group differences restricting the group inclusion to PD participants with mild motor symptoms or disease duration less than 10 years.: Processing speed and semantic verbal fluency were significantly lower in the PD group ( = -3.77, 95% CIs [-5.76 to -1.77], p < .001, and = -2.02, 95% CIs [-3.12, -0.92], p < .001, respectively), even after excluding those with moderate to severe motor symptoms ( = -2.73, 95% CIs [-4.94 to -0.53], p = .015 and = -2.11, 95% CIs [-3.32 to -0.91], p < .001, respectively) or longer disease duration ( = -3.89, 95% CIs [-6.14 to -1.63], p < .001 and = -1.58, 95% CIs [-2.78 to -0.37], p = .010, respectively). Semantic verbal fluency remained significantly negatively associated with PD diagnosis after controlling for processing speed ( = -1.66, 95% CIs [-2.79 to -0.53], p = .004).: Subtle decline in specific cognitive domains may be present among people diagnosed with PD but without evidence to support a formal cognitive diagnosis. These results suggest the importance of early awareness of the potential for diminishing aspects of cognition in PD even among those without mild cognitive impairment or dementia.
帕金森病(PD)与一系列认知缺陷相关。很少有研究仔细检查 PD 对不符合轻度认知障碍或痴呆正式标准的患者认知的微妙影响。因此,本研究的目的是在一个特征明确的队列中描述无认知障碍的 PD 患者的认知影响。
无认知障碍的参与者(122 名 PD 患者,122 名年龄和性别匹配的健康志愿者)接受了广泛的认知测试。线性回归分析比较了诊断组在认知测量中的表现。对于组间差异显著的认知任务,进一步的分析检查了将组纳入限制为 PD 参与者有轻度运动症状或病程小于 10 年的组间差异。
PD 组的加工速度和语义流畅性明显较低(= -3.77,95%置信区间 [-5.76 至 -1.77],p <.001 和 = -2.02,95%置信区间 [-3.12 至 -0.92],p <.001),即使排除了那些有中度至重度运动症状的人(= -2.73,95%置信区间 [-4.94 至 -0.53],p =.015 和 = -2.11,95%置信区间 [-3.32 至 -0.91],p <.001)或更长的病程(= -3.89,95%置信区间 [-6.14 至 -1.63],p <.001 和 = -1.58,95%置信区间 [-2.78 至 -0.37],p =.010)。在控制加工速度后,语义流畅性仍然与 PD 诊断显著负相关(= -1.66,95%置信区间 [-2.79 至 -0.53],p =.004)。
在诊断为 PD 但没有证据支持正式认知诊断的人群中,特定认知领域的细微下降可能存在。这些结果表明,即使在没有轻度认知障碍或痴呆的人群中,也需要早期意识到 PD 认知能力下降的可能性。