Chang Ting-Ya, Yang Chun-Pai, Chen Yi-Huei, Lin Ching-Heng, Chang Ming-Hong
Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan.
Front Neurol. 2021 Dec 24;12:748096. doi: 10.3389/fneur.2021.748096. eCollection 2021.
Parkinson's disease (PD) manifests with dominant motor symptoms and a wide range of non-motor symptoms (NMS). Dementia is one of the most disabling and exhausting NMS throughout the clinical course. We conducted a population-based, age-stratified, retrospective cohort study to investigate the incidence rate and risk of dementia of patients with newly diagnosed PD, and linked to the clinicopathological PD subtypes. Patients with newly diagnosed PD (PD group, = 760) and control subjects (non-PD group, = 3,034) were selected from the Taiwan's National Health Insurance Research Database from January 2001 to December 2005. The dementia incidence rate and dementia-free survival rate were calculated. The overall dementia incidence rate was 17.5 and 5.7 per 1,000 person-years in PD and non-PD groups, respectively. The PD group had a significantly higher overall risk of dementia than controls ( < 0.001). The younger PD patients had a lower dementia incidence rate than the older PD patients, but a higher dementia risk compared to the same age of controls (<60 years, adjusted HR 6.55, 95% CI 1.56-27.48, = 0.010). The dementia-free survival rate was significantly lower in the PD group compared to the non-PD group during follow-up ( < 0.001). In our study, the older age of onset in PD patients resulted in a higher incidence rate of dementia. In the young age of PD patients, the incidence rate of dementia was lower than the older PD patients, but the dementia risk was higher than controls of the same age. These findings possibly implied that there were different pathogenesis and pathologies causing dementia in younger and older PD patients.
帕金森病(PD)表现为主要的运动症状以及广泛的非运动症状(NMS)。痴呆是整个临床病程中最具致残性和使人疲惫的非运动症状之一。我们进行了一项基于人群、年龄分层的回顾性队列研究,以调查新诊断帕金森病患者的痴呆发病率和风险,并与临床病理帕金森病亚型相关联。从2001年1月至2005年12月的台湾全民健康保险研究数据库中选取新诊断的帕金森病患者(帕金森病组,n = 760)和对照对象(非帕金森病组,n = 3034)。计算痴呆发病率和无痴呆生存率。帕金森病组和非帕金森病组的总体痴呆发病率分别为每1000人年17.5例和5.7例。帕金森病组的总体痴呆风险显著高于对照组(P < 0.001)。年轻的帕金森病患者痴呆发病率低于老年帕金森病患者,但与同年龄对照组相比痴呆风险更高(<60岁,调整后风险比6.55,95%置信区间1.56 - 27.48,P = 0.010)。在随访期间,帕金森病组的无痴呆生存率显著低于非帕金森病组(P < 0.001)。在我们的研究中,帕金森病患者发病年龄较大导致痴呆发病率较高。在年轻的帕金森病患者中,痴呆发病率低于老年帕金森病患者,但痴呆风险高于同年龄对照组。这些发现可能意味着年轻和老年帕金森病患者导致痴呆的发病机制和病理不同。