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识别导致早期帕金森病认知特征的共病和生活方式因素。

Identifying comorbidities and lifestyle factors contributing to the cognitive profile of early Parkinson's disease.

机构信息

Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Mas Casanovas 90, 08041, Barcelona, Spain.

Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain.

出版信息

BMC Neurol. 2021 Dec 8;21(1):477. doi: 10.1186/s12883-021-02485-1.

Abstract

BACKGROUND

Identifying modifiable risk factors for cognitive impairment in the early stages of Parkinson's disease (PD) and estimating their impact on cognitive status may help prevent dementia (PDD) and the design of cognitive trials.

METHODS

Using a standard approach for the assessment of global cognition in PD and controlling for the effects of age, education and disease duration, we explored the associations between cognitive status, comorbidities, metabolic variables and lifestyle variables in 533 PD participants from the COPPADIS study.

RESULTS

Among the overall sample, 21% of participants were classified as PD-MCI (n = 114) and 4% as PDD (n = 26). The prevalence of hypertension, diabetes and dyslipidemia was significantly higher in cognitively impaired patients while no between-group differences were found for smoking, alcohol intake or use of supplementary vitamins. Better cognitive scores were significantly associated with regular physical exercise (p < 0.05) and cognitive stimulation (< 0.01). Cognitive performance was negatively associated with interleukin 2 (Il2) (p < 0.05), Il6 (p < 0.05), iron (p < 0.05), and homocysteine (p < 0.005) levels, and positively associated with vitamin B12 levels (p < 0.005).

CONCLUSIONS

We extend previous findings regarding the positive and negative influence of various comorbidities and lifestyle factors on cognitive status in early PD patients, and reinforce the need to identify and treat potentially modifiable variables with the intention of exploring the possible improvement of the global cognitive status of patients with PD.

摘要

背景

识别帕金森病(PD)早期认知障碍的可调节风险因素,并评估其对认知状态的影响,可能有助于预防痴呆(PDD)和设计认知试验。

方法

我们使用评估 PD 患者整体认知的标准方法,并控制年龄、教育和疾病持续时间的影响,在来自 COPPADIS 研究的 533 名 PD 参与者中,探讨了认知状态、合并症、代谢变量和生活方式变量之间的关系。

结果

在整个样本中,21%的参与者被归类为 PD-MCI(n=114),4%为 PDD(n=26)。在认知受损患者中,高血压、糖尿病和血脂异常的患病率明显较高,而在吸烟、饮酒或使用补充维生素方面,两组之间没有差异。更好的认知评分与定期体育锻炼(p<0.05)和认知刺激(<0.01)显著相关。认知表现与白细胞介素 2(Il2)(p<0.05)、白细胞介素 6(Il6)(p<0.05)、铁(p<0.05)和同型半胱氨酸(p<0.005)水平呈负相关,与维生素 B12 水平呈正相关(p<0.005)。

结论

我们扩展了之前关于各种合并症和生活方式因素对早期 PD 患者认知状态的积极和消极影响的发现,并强调需要识别和治疗潜在的可调节变量,以探索改善 PD 患者整体认知状态的可能性。

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