CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
Department of Neurology, Hospital Universitario de A Coruña (HUAC), Complejo Hospitalario Universitario de A Coruña (CHUAC), C/As Xubias 84, 15006, A Coruña, Spain.
J Neurol. 2023 Dec;270(12):5793-5812. doi: 10.1007/s00415-023-11921-w. Epub 2023 Aug 14.
Patients with young-onset Parkinson's disease (YOPD) have a slower progression. Our aim was to analyze the change in cognitive function in YOPD compared to patients with a later onset and controls.
Patients with Parkinson's disease (PD) and controls from the COPPADIS cohort were included. Cognitive function was assessed with the Parkinson's Disease Cognitive Rating Scale (PD-CRS) at baseline (V0), 2-year ± 1 month (V2y), and 4-year ± 3 months follow-up (V4y). Regarding age from symptoms onset, patients were classified as YOPD (< 50 years) or non-YOPD (≥ 50). A score in the PD-CRS < 81 was defined as cognitive impairment (CI): ≤ 64 dementia; 65-80 mild cognitive impairment (MCI).
One-hundred and twenty-four YOPD (50.7 ± 7.9 years; 66.1% males), 234 non-YOPD (67.8 ± 7.8 years; 59.3% males) patients, and 205 controls (61 ± 8.3 years; 49.5% males) were included. The score on the PD-CRS and its subscore domains was higher at all visits in YOPD compared to non-YOPD patients and to controls (p < 0.0001 in all analysis), but no differences were detected between YOPD patients and controls. Only non-YOPD patients had significant impairment in their cognitive function from V0 to V4y (p < 0.0001). At V4y, the frequency of dementia and MCI was 5% and 10% in YOPD compared to 25.2% and 22.3% in non-YOPD patients (p < 0.0001). A lower score on the Parkinson's Disease Sleep Scale at baseline was a predictor of CI at V4y in YOPD patients (Adjusted R = 0.61; OR = 0.965; p = 0.029).
Cognitive dysfunction progressed more slowly in YOPD than in non-YOPD patients.
早发型帕金森病（YOPD）患者的疾病进展较为缓慢。我们旨在分析与晚发型帕金森病患者和对照组相比，YOPD 患者认知功能的变化。
纳入了 COPPADIS 队列中的帕金森病患者和对照组。在基线（V0）、2 年±1 个月（V2y）和 4 年±3 个月随访（V4y）时使用帕金森病认知评定量表（PD-CRS）评估认知功能。根据症状发病年龄，患者被分为 YOPD（<50 岁）或非 YOPD（≥50 岁）。PD-CRS 评分<81 定义为认知障碍（CI）：≤64 分为痴呆；65-80 分为轻度认知障碍（MCI）。
共纳入 124 例 YOPD（50.7±7.9 岁；66.1%为男性）、234 例非 YOPD（67.8±7.8 岁；59.3%为男性）患者和 205 例对照组（61±8.3 岁；49.5%为男性）。与非 YOPD 患者和对照组相比，YOPD 患者在所有随访时间点的 PD-CRS 评分及其亚域评分均较高（所有分析中 p<0.0001），但 YOPD 患者与对照组之间无差异。只有非 YOPD 患者的认知功能从 V0 到 V4y 显著受损（p<0.0001）。在 V4y，YOPD 患者痴呆和 MCI 的频率分别为 5%和 10%，而非 YOPD 患者分别为 25.2%和 22.3%（p<0.0001）。基线时帕金森病睡眠量表评分较低是 YOPD 患者 V4y 时 CI 的预测因素（调整后的 R=0.61；OR=0.965；p=0.029）。
与非 YOPD 患者相比，YOPD 患者的认知功能障碍进展更缓慢。
