Kang Sung Hoon, Choi Yunjin, Chung Su Jin, Kim Chi Kyung, Kim Ji Hyun, Oh Kyungmi, Yoon Joon Shik, Cho Geum Joon, Koh Seong-Beom
Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Biomedical Research Institute, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Eur J Neurol. 2023 Apr;30(4):911-919. doi: 10.1111/ene.15689. Epub 2023 Feb 7.
We aimed to investigate the incidence rate of Parkinson's disease dementia (PDD) according to age and disease duration by sex. Furthermore, we explored the effect of each cardiometabolic syndrome and depression on the incidence of PDD.
Using data from the Korean National Health Insurance Service, 79,622 patients with de novo Parkinson's disease (PD) aged ≥40 years between January 2002 and December 2010 were followed to December 2019. We analyzed the incidence of PDD according to age at PD diagnosis and disease duration. To determine cardiometabolic syndromes and depression that affected PDD, we used Fine and Gray competing regression after controlling for age and sex.
During the 12.5-year follow-up period, the incidence of PDD increased with age at PD diagnosis (0.81-45.31 per 1000 person-years among those aged 40-44 and over 80 years, respectively) and longer disease duration (22.68 per 1000 person-years in 1-2 years to 34.16 per 1000 person-years in 15-16 years). Hypertension (subdistribution hazard ratio [SHR] = 1.11; 95% confidence interval [CI] 1.07-1.16), diabetes (SHR = 1.09; 95% CI 1.05-1.14), dyslipidemia (SHR = 1.15; 95% CI 1.11-1.20), and depression (SHR = 1.36; 95% CI 1.30-1.41) independently increased the risk for PDD.
Our findings provide insights into cardiometabolic syndromes as modifiable risk factors for incident PDD. Furthermore, our results will help in designing public health policies with respect to controlling cardiometabolic syndromes and depression to prevent incident PDD in patients with PD.
我们旨在按年龄、疾病病程及性别调查帕金森病痴呆（PDD）的发病率。此外，我们还探究了每种心脏代谢综合征及抑郁症对PDD发病率的影响。
利用韩国国民健康保险服务的数据，对2002年1月至2010年12月期间年龄≥40岁的79622例新发帕金森病（PD）患者进行随访至2019年12月。我们根据PD诊断时的年龄和疾病病程分析了PDD的发病率。为确定影响PDD的心脏代谢综合征和抑郁症，我们在控制年龄和性别后使用了Fine和Gray竞争回归模型。
在12.5年的随访期内，PDD的发病率随PD诊断时年龄的增加而上升（40 - 44岁和80岁以上人群分别为每1000人年0.81 - 45.31例），且随疾病病程延长而上升（病程1 - 2年时为每1000人年22.68例，15 - 16年时为每1000人年34.16例）。高血压（亚分布风险比[SHR]=1.11；95%置信区间[CI] 1.07 - 1.16）、糖尿病（SHR = 1.09；95% CI 1.05 - 1.14）、血脂异常（SHR = 1.15；95% CI 1.11 - 1.20）和抑郁症（SHR = 1.36；95% CI 1.30 - 1.41）均独立增加PDD风险。
我们的研究结果为心脏代谢综合征作为新发PDD的可改变风险因素提供了见解。此外，我们的结果将有助于制定公共卫生政策，以控制心脏代谢综合征和抑郁症，预防PD患者发生PDD。
