帕金森病患者身体机能与认知之间的纵向关联。
Longitudinal associations between physical performance and cognition in individuals with Parkinson's disease.
作者信息
Petkus Andrew J, Foreman Ryan P, Pilgrim Matthew, Kim Aram, Hong Elise, Fisher Beth E, Van Horn John D, Wing David, Jakowec Michael W, Schiehser Dawn M, Petzinger Giselle M
机构信息
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Graduate Program, Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA 90033, USA.
出版信息
Clin Park Relat Disord. 2025 Jul 17;13:100370. doi: 10.1016/j.prdoa.2025.100370. eCollection 2025.
BACKGROUND
Declines in physical performance and cognition commonly occur in people with Parkinson's disease (PwPD) and negatively impacts Quality of Life. Understanding the cross-sectional and longitudinal associations between physical performance and cognition may provide guidance to prevent or treat their decline in PwPD.
OBJECTIVE
This study investigated the cross-sectional and longitudinal associations between physical performance and cognition in PwPD.
METHODS
Physical performance and cognition were evaluated at baseline and at two-year follow-up in PwPD. Physical performance was measured using Ten-Set Test, Time Up and Go, Physical Performance Test, and Short-Physical Performance Battery Test. Neuropsychological assessments included global cognition and domain-specific cognitive functions from which Mild Cognitive Impairment (MCI) status was ascertained. Regression analyses estimated baseline associations between physical performance and cognition and if changes in physical performance were associated with changes in cognition. Sub-analysis determined which physical performance test was most significantly associated with cognition.
RESULTS
At baseline, better physical performance was associated with lower odds of having MCI as well as better global cognition, attention, and executive function. Baseline physical performance was also associated with changes in executive function and attention (baseline to two-year follow-up). PwPD experiencing greater decline in physical performance experienced more decline in executive function and visuospatial skills.
CONCLUSION
Physical performance and cognition are closely inter-related in PwPD. Findings are clinically relevant since impaired physical performance may inform those PwPD most likely to demonstrate greatest cognitive deficits over time and who may benefit from treatment strategies, such as neurorehabilitation, for improving cognition and reducing its decline.
背景
帕金森病患者（PwPD）常出现身体机能和认知能力下降，这对生活质量产生负面影响。了解身体机能与认知之间的横断面和纵向关联，可能为预防或治疗PwPD患者的机能和认知能力下降提供指导。
目的
本研究调查了PwPD患者身体机能与认知之间的横断面和纵向关联。
方法
对PwPD患者在基线期和两年随访期进行身体机能和认知评估。身体机能通过十组试验、起立行走试验、身体机能测试和简短身体机能量表测试进行测量。神经心理学评估包括整体认知和特定领域认知功能，并据此确定轻度认知障碍（MCI）状态。回归分析估计身体机能与认知之间的基线关联，以及身体机能变化是否与认知变化相关。亚分析确定哪种身体机能测试与认知关联最为显著。
结果
在基线期，较好的身体机能与较低的MCI发生率以及较好的整体认知、注意力和执行功能相关。基线身体机能还与执行功能和注意力的变化（从基线期到两年随访期）相关。身体机能下降幅度较大的PwPD患者，其执行功能和视觉空间技能下降更多。
结论
PwPD患者的身体机能与认知密切相关。这些发现具有临床相关性，因为身体机能受损可能提示哪些PwPD患者随着时间推移最有可能出现最大程度的认知缺陷，以及哪些患者可能从改善认知和减少认知衰退的治疗策略（如神经康复）中获益。
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