Demographic and clinical variables as differentiating predictors of cognitive disorders in Parkinson’s disease

Abstract Objective: to analyze demographic and clinical variables as predictors of cognitive disorders in Parkinson’s disease (PD). Method: a cross-sectional descriptive study was carried out at the Pro-Parkinson Program of the Hospital das Clínicas of the Federal University of Pernambuco. The instruments used were the Mini Mental State Examination (MMSE), Scales for Outcomes in Parkinson’s disease - Cognition (SCOPA-COG), the Hoehn & Yahr Staging Scale (HY), the Unified Parkinson’s Disease Rating Scale part 3 (UPDRS-III), and the 15-item Yesavage Geriatric Depression Scale (GDS-15). A multiple linear regression model was used for the predictive outcome and the Mann-Whitney test was used to compare the elderly and the non-elderly groups. Results: the sociodemographic data of 85 people were collected and the participants underwent a cognitive profile evaluation (MMSE and SCOPA-COG) and clinical evaluation (HY, UPDRS-III, GDS-15). Multiple regression analysis found significant results for age, work activity, and tremor index, explaining 59% of the variability of SCOPA-COG. There was an inverse correlation with age and work activity and a direct correlation with tremors. The SCOPA-COG and MEEM scores were significantly lower in elderly patients, with an emphasis on executive functions. Conclusion: the predictors of cognitive impairment were age, work activity, and tremors. Cognitive impairment was greater in elderly patients with PD, especially for executive functions.

摘要 研究目的：分析人口统计学与临床变量作为帕金森病（Parkinson’s Disease, PD）认知障碍的预测因子。研究方法：于伯南布哥联邦大学临床医院帕金森专科项目中开展一项横断面描述性研究。所用评估工具包括简易精神状态检查表（Mini Mental State Examination, MMSE）、帕金森病结局量表-认知维度（Scales for Outcomes in Parkinson’s disease - Cognition, SCOPA-COG）、赫恩-雅尔分期量表（Hoehn & Yahr Staging Scale, HY）、帕金森病统一评定量表第3部分（Unified Parkinson’s Disease Rating Scale part 3, UPDRS-III）以及15项耶拉维奇老年抑郁量表（15-item Yesavage Geriatric Depression Scale, GDS-15）。采用多元线性回归模型进行预测性结局分析，使用曼-惠特尼检验（Mann-Whitney test）比较老年与非老年两组人群。研究结果：共纳入85名受试者并收集其社会人口学数据，所有参与者均接受了认知特征评估（MMSE与SCOPA-COG）及临床评估（HY、UPDRS-III、GDS-15）。多元回归分析显示，年龄、职业活动与震颤指数具有显著预测效应，可解释SCOPA-COG评分59%的变异度。年龄与职业活动呈负相关，震颤则呈正相关。老年帕金森病患者的SCOPA-COG与MMSE评分显著更低，且以执行功能受损最为显著。研究结论：年龄、职业活动与震颤为帕金森病认知障碍的预测因子。老年帕金森病患者的认知损害更为严重，尤以执行功能障碍为著。