The Related Research Of Parkinson's Disease With Mild Cognitive Impairment

Background Cognitive decline is well recognized over time in Parkinson's disease (PD) and can range from mild impairment to florid dementia. Study PD patients with cognitive impairment contributed to the early detection of PD with mild cognitive impairment(PD-MCI)individuals. Defining PD-MCI offers an opportunity for further study of cognitive impairment in PD and targets for earlier therapeutic intervention. Investigate the incidence of PD-MCI, reveal its characteristics of cognitive impairment, and to explore related risk factors are useful for prevent the occurrence of dementia or improve patients' quality of life. So far, there is no unity criteria for evaluate cognitive function in PD patients at home or abroad, its incidence, the rate of change to dementia and the related risk factors are still controversial.This study was to assess the course of the different Cambridge Cognitive Examination-Chinese version (CAMCOG-C) domains in a representative community population of PD patients all previously found not to have significant cognitive impairment, apply a set of criteria for cognitive impairment based on the Petersen criteria for MCI to our sample of patients with PD and to report its properties. Objective To ascertain the feasibility and sensitivity of CAMCOG-C as a cognitive assessment tool for patients with Parkinson's disease (PD). Investigate the cognitive impairment characteristics in Parkinson's disease(PD) with mild cognitive impairment(PD-MCI)as well as their related risk factors. Methods Investigate the epidemiological data of all the subjects, including age, sex, occupation, habits, educational level, family history, onset age and initial symptoms and so on. In all of the participants, a battery of neuropsychological tests were selected to identify the cognitive deficits; the 2 cognitive screening tests utilized in this study were the MMSE and the CAMCOG-C; the severity of disease was measured using the Hoehn/Yahr;the motor portion of the UPDRS and Webster scale were used to evaluate motor function and PD-MCI were classified according to modified Petersen's criteria. According to the cut-off values of MMSE and CAMCOG-C, all of the participants were divided into cognitive normal and cognitive impairment. Compare the age, cognitive, movement disorder and other diseases characteristics of those two groups. Those subjects screened by a MMSE of 25-30 as not having significant cognitive impairment were invited to take part in this subsequent study in which they were further cognitively assessed using CAMCOG-C. Compare the CAMCOG-C score of MMSE test have no dementia (MMSE>24) to normal elderly control group, study the cognitive impairment characteristics of the PD patients with MMSE>24, reveal the CAMCOG-C was a viable and useful cognitive screening tool for use in PD. According to clinical symptoms, cognitive function evaluation and diagnostic criteria; all of the subjects were divided into 3 groups: PD cognitively normal, PD with mild cognitive impairment and PD dementia. Investigate the incidence of PD-MCI, compared three groups of the characteristics of disease and cognitive impairment, Pearson correlation coefficients were used to assess the relationship between the CAMCOG-C test results of PD patients with cognitive impairment and the characteristics of their disease itself, reveal the characteristics of cognitive impairment and their possible related factors. Results 1,Of the 89 PD patients, 33 demonstrated cognitive impairment on MMSE (score≤24) compare with the remaining 56 patients (MMSE﹥24). There were significant differences in age, activities of daily living (ADL) and Hoehn/Yahr (P<0.001~0.05), not in the Webster scale and UPDRS-motor score. Forty-seven patients of 89 PD were found to have evidence of cognitive impairment on the CAMCOG-C (score<80) while the others (score≥80) had no dementia. There were significant differences in ADL, Hoehn/Yahr and Webster scale, UPDRS-motor score(P<0.01~0.05)between two groups. Compared with the normal elderly, PD with MMSE﹥24 had significant impairments in the subscores of CAMCOG-C, including language expression, remote and recent memory, praxis (P<0.001~0.05). 2,Of the 89 PD cases, 56(63%) were cognitively normal (PDCOGNL), 20(22%) had MCI and 13(15%) met criteria for PD dementia (PDD).The cognitive domain abnormal in PD-MCI was orientation, language, memory, attention, praxis, thinking and perception(P<0.05-0.001).The PDCOGNL group had no significant differences for age and PD onset versus the PD-MCI group, but the years of education had significant differences(q=3.270,P<0.05); PD-MCI also had significant differences for the years of education (q=1.705,p<0.05)versus the PDD, but the PDD group had significant differences for all of them (P<0.01-0.001) compare to the PDCOGNL group; there were no significant differences among three groups for years of PD duration. Hoehn/Yahr and Webster scale, UPDRS-motor score had negative correlation with PD cognitive function. Conclusions CAMCOG-C, which is a viable and useful cognitive screening tool for PD patients, has more specificity and sensitivity than MMSE. A stage of clinical cognitive impairment in PD can be defined between PDCOGNL and PDD that characterized as PD-MCI. There are multiple domains impaired in PD-MCI. The risk factors of PD cognitive impairment include the elder, later onset and lower education level. There are negative correlation between the severity of disease, motor function and PD cognitive function.