帕金森氏病的痴呆危险：以社区人群为基础的前瞻性研究
OBJECTIVE: To calculate the incidence of and determine possible risk factors
for dementia in PD. BACKGROUND: Dementia has important clinical consequences
for patients with PD and their caregivers, but the incidence is unknown.
METHODS: A population-based cohort of nondemented patients with PD (n
= 171) from the county of Rogaland, Norway, was assessed at baseline and
4.2 years later with a comprehensive evaluation of motor, cognitive, and
neuropsychiatric symptoms. The diagnosis of dementia was made according
to the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition,
revised (DSM-III-R) criteria, based on interview of the patient and a
caregiver, cognitive rating scales, and neuropsychologic tests. A representative
sample of 3,062 nondemented elderly subjects without PD served as control
group. RESULTS: Forty-three patients with PD were demented at follow-up
evaluation, equivalent to an incidence rate of 95.3 per 1,000 person-years
(95% CI, 68.2 to 122.0). The risk for the development of dementia in patients
with PD relative to the control subjects after adjusting for age, sex,
and education was 5.9 (95% CI, 3.9 to 9.1). Predictive factors at baseline
for dementia in PD in addition to age were Hoehn & Yahr score >2 (OR,
3.4; 95% CI, 1.3 to 8.6) and Mini-Mental State Examination score <29 (OR,
3.3; 95% CI, 1.3 to 8.2). CONCLUSIONS: Patients with PD have an almost
sixfold increased risk for becoming demented compared with subjects without
PD. [引自Neurology 2001 Mar 27;56(6):730-6]
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