期刊
NEUROLOGY
卷 95, 期 12, 页码 E1650-E1659出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0000000000010347
关键词
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资金
- Basic Science Research Program through the National Research Foundation of Korea - Ministry of Science, ICT and Future Planning [NRF-2019R1A2C2085462]
- Ministry of Education [NRF-2018R1D1A1B07048959]
Objectives To investigate which baseline neuropsychological profile predicts the risk of developing dementia in early-stage Parkinson disease (PD). Methods We retrospectively reviewed detailed medical records of 350 drug-naive patients with early-stage PD (follow-up >3 years) who underwent a detailed neuropsychological test at initial assessment. Factor analysis was conducted to determine cognitive profiles that yielded 4 cognitive function factors: factor 1, visual memory/visuospatial; factor 2, verbal memory; factor 3, frontal/executive; and factor 4, attention/working memory/language. Subsequently, we assessed the effect of these cognitive function factors on the risk for dementia conversion. We also constructed a nomogram to calculate the risk for developing dementia over a 5-year follow-up period based on these cognitive profiles. Results Cox regression analysis demonstrated that a higher composite score of factor 1 (hazard ratio [HR] 0.558, 95% confidence interval [CI] 0.427-0.730), factor 2 (HR 0.768, 95% CI 0.596-0.991), and factor 3 (HR 0.425, 95% CI 0.305-0.593) was associated with a lower risk for dementia conversion, while factor 3 had the most predictive power. The nomogram had a fair ability (Heagerty integrated area under the curve 0.763) to estimate the risk for dementia conversion within 5 years. The composite scores of factor 3 contributed more to the occurrence of dementia in PD than those of the other cognitive function factors. Conclusions These findings suggest that these factor analysis-derived cognitive profiles can be used to predict dementia conversion in early-stage PD. In addition, frontal/executive dysfunction contributes most to the occurrence of dementia in PD.
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