Rajput A H, Offord K, Beard C M, Kurland L T
Adv Neurol. 1984;40:229-34.
In a 13-year (1967-1979) survey of Rochester, Minnesota residents, 138 new cases of parkinsonism were recognized. For each case, 2 age- and sex-matched residents from the community were identified who attended the same medical facility as the patient did. Original medical records for 40 years preceding the diagnosis and control selection were reviewed on all patients and controls. Diagnosis of dementia was made three times more frequently in patients than in the controls, but the age at diagnosis was similar in the two groups. Those cases where neither of the three matched individuals had dementia at the time of initial recognition of parkinsonism were further followed. Dementia emerged significantly more frequently in patients than in controls. The subgroup of patients treated with levodopa had higher frequency of dementia than the controls. It is concluded that dementia is significantly more common in parkinsonian patients than in a comparable population. Dementia is believed to be either an integral part of the disease process or these patients are prone to some other illness that produces dementia. Our data conclusively show that dementia is not a reflection of old age. Higher incidence of dementia in levodopa-treated cases may be due to case-selection artifact or an as yet unrecognized effect of levodopa.
在一项针对明尼苏达州罗切斯特市居民的为期13年（1967 - 1979年）的调查中，共确认了138例帕金森症新病例。对于每一例患者，从社区中挑选出2名年龄和性别与之匹配、且与患者就诊于同一医疗机构的居民作为对照。研究人员查阅了所有患者及对照在诊断前及对照选择前40年的原始病历。结果发现，患者被诊断为痴呆的频率是对照的3倍，但两组的诊断年龄相似。对于那些在最初确诊帕金森症时，3名匹配个体中均无痴呆的病例，进行了进一步随访。结果显示，患者出现痴呆的频率显著高于对照。接受左旋多巴治疗的患者亚组中，痴呆的发生率高于对照。研究得出结论，帕金森症患者中痴呆的发生率显著高于可比人群。痴呆被认为要么是疾病进程的一个组成部分，要么是这些患者易患某种导致痴呆的其他疾病。我们的数据确凿地表明，痴呆并非衰老的反映。左旋多巴治疗病例中痴呆发生率较高，可能是由于病例选择偏差或左旋多巴尚未被认识到的某种作用。
