Pourzinal Dana, Lawson Rachael A, Yarnall Alison J, Williams-Gray Caroline H, Barker Roger A, Yang Jihyun, McMahon Katie L, O'Sullivan John D, Byrne Gerard J, Dissanayaka Nadeeka N
Faculty of Medicine The University of Queensland Centre for Clinical Research Herston Queensland Australia.
Translational and Clinical Research Institute Newcastle University Newcastle Newcastle Upon Tyne UK.
Alzheimers Dement (Amst). 2024 Aug 5;16(3):e12625. doi: 10.1002/dad2.12625. eCollection 2024 Jul-Sep.
A subset of people with Parkinson's disease (PD) develop dementia faster than others. We aimed to profile PD cognitive subtypes at risk of dementia based on their rate of cognitive decline.
Latent class mixed models stratified subtypes in Parkinson's Progression Markers Initiative (PPMI) (= 770) and ICICLE-PD (= 212) datasets based on their decline in the Montreal Cognitive Assessment over at least 4 years. Baseline demographic and cognitive data at diagnosis were compared between subtypes to determine their clinical profile.
Four subtypes were identified: two with stable cognition, one with steady decline, and one with rapid decline. Performance on Judgement of Line Orientation, but not category fluency, was associated with a steady decline in the PPMI dataset, and deficits in category fluency, but not visuospatial function, were associated with a steady decline in the ICICLE-PD dataset.
People with PD susceptible to cognitive decline demonstrate unique clinical profiles at diagnosis, although this differed between cohorts.
Four cognitive subtypes were revealed in two Parkinson's disease samples.Unique profiles of cognitive impairment were related to cognitive decline.Judgement of Line Orientation/category fluency predictive of steady decline.Global deficits related to rapid cognitive decline and increased dementia risk.
一部分帕金森病（PD）患者比其他人更快出现痴呆。我们旨在根据认知衰退速度对有痴呆风险的PD认知亚型进行描述。
在帕金森病进展标志物倡议（PPMI）（n = 770）和ICICLE-PD（n = 212）数据集中，基于至少4年的蒙特利尔认知评估衰退情况，采用潜在类别混合模型对亚型进行分层。比较各亚型在诊断时的基线人口统计学和认知数据，以确定其临床特征。
确定了四种亚型：两种认知稳定，一种稳步衰退，一种快速衰退。在PPMI数据集中，线方向判断（而非类别流畅性）的表现与稳步衰退相关；在ICICLE-PD数据集中，类别流畅性缺陷（而非视觉空间功能）与稳步衰退相关。
易出现认知衰退的PD患者在诊断时有独特的临床特征，尽管不同队列之间存在差异。
在两个帕金森病样本中揭示了四种认知亚型。认知障碍的独特特征与认知衰退相关。线方向判断/类别流畅性可预测稳步衰退。整体缺陷与快速认知衰退和痴呆风险增加相关。
