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使用社区痴呆筛查工具评估帕金森病患者认知障碍的频率、模式及预测因素

Frequency, pattern and predictors of cognitive impairments in patients with Parkinson's disease using the Community Screening Instrument for Dementia.

作者信息

Ogbimi Ewere Marie, Akemokwe Fatai Momodu, Ogunrin Olubunmi

机构信息

(formerly Neurology Unit, Department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria) Neurology Unit, Department of Medicine, Delta State University, Abraka, Nigeria.

(formerly Neurology Unit, Department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria) Department of Neurology, University of Kentucky, Lexington, KY, United States.

出版信息

Front Hum Neurosci. 2023 Jun 27;17:1126526. doi: 10.3389/fnhum.2023.1126526. eCollection 2023.

Abstract

BACKGROUND

Parkinson's disease (PD) is a chronic neurodegenerative disorder complicated by cognitive dysfunctions which are associated with increased caregiver burden, pressure on community health facilities, and mortality in affected patients. Most of the data concerning cognitive dysfunctions in PD are from studies conducted in Europe and North America, but there is paucity of data from Sub-Saharan Africa.

OBJECTIVE

The objective of this study is to determine the frequency, pattern and predictors of cognitive impairments amongst patients with Parkinson's disease.

MATERIALS AND METHODS

This was a cross sectional case control study carried out at a tertiary health facility in South-south Nigeria. Participants with PD were consecutively recruited from the neurology outpatient clinics. Demographic and disease-specific data were obtained with the use of a pre-tested questionnaire. Cognitive performance of thirty patients with PD were compared with thirty demographically matched controls using the Community Screening Instrument for Dementia (CSID). CSID was already validated among Nigerians.

RESULTS

The frequency of cognitive impairment using the CSID was 50% for PD patients (3.3% for controls). Poor cognitive performance was observed across several cognitive domains including language, executive dysfunction, psychomotor speed, and constructional apraxia among PD patients. The independent predictors of the overall cognitive impairment in patients with PD determined by logistic regression analysis include recall deficiency ( = 0.007), impairment with naming ( = 0.044), apraxia ( = 0.003), Hoen&Yahr staging ( = 0.046), UPDRS score ( = 0.015) and age at presentation ( = 0.014).

CONCLUSION

Cognitive impairments occur more frequently in patients with PD compared to controls. This study also demonstrated the predictive role of severity of disease based on Hoehn &Yahr staging and UPDRS score, and presence of recall deficiency, poor naming ability and apraxia.

摘要

背景

帕金森病(PD)是一种慢性神经退行性疾病,常伴有认知功能障碍,这与照顾者负担加重、社区卫生设施压力增大以及患者死亡率上升有关。大多数关于帕金森病认知功能障碍的数据来自欧洲和北美的研究,但撒哈拉以南非洲地区的数据却很少。

目的

本研究的目的是确定帕金森病患者认知障碍的频率、模式及预测因素。

材料与方法

这是一项在尼日利亚西南部一家三级医疗机构开展的横断面病例对照研究。帕金森病患者从神经内科门诊连续招募。使用预先测试的问卷获取人口统计学和疾病相关数据。使用痴呆社区筛查工具(CSID)将30例帕金森病患者的认知表现与30例人口统计学匹配的对照进行比较。CSID已在尼日利亚人群中得到验证。

结果

使用CSID评估,帕金森病患者认知障碍的频率为50%(对照组为3.3%)。在帕金森病患者中,在包括语言、执行功能障碍、精神运动速度和结构性失用等多个认知领域均观察到认知表现不佳。通过逻辑回归分析确定的帕金森病患者总体认知障碍的独立预测因素包括回忆缺陷(P = 0.007)、命名障碍(P = 0.044)、失用(P = 0.003)、霍恩&雅尔分期(P = 0.046)、统一帕金森病评定量表(UPDRS)评分(P = 0.015)和发病年龄(P = 0.014)。

结论

与对照组相比,帕金森病患者认知障碍的发生率更高。本研究还证明了基于霍恩&雅尔分期和UPDRS评分的疾病严重程度、回忆缺陷、命名能力差和失用的预测作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0471/10333480/29b0127b3dfd/fnhum-17-1126526-g001.jpg

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