Analysis Of The Clinical Influencing Factors And Clinical Characteristics Research Of Cognitive Impairment In Parkinson's Disease

Objectives:To analyze the clinical influencing factors of cognitive impairment in Parkinson's disease(PD)patients in China,explore the correlation mechanism between them and cognitive impairment,analyze the internal correlation of influencing factors,and investigate the characteristics of cognitive impairment.Methods:According to the diagnostic criteria of Parkinson's disease with mild cognitive impairment(PD-MCI)and Parkinson's disease with dementia(PDD)issued by the movement disorder society(MDS),the overall cognitive function was evaluated by Montreal Cognitive Assessment(MoCA),scores of each subtest of MoCA were recorded,patients were divided into PD with normal cognitive group(PD-NC)and PD with cognitive impairment group(PD-CI).The date of gender,age,age of onset(early-onset and late-onset),level of education,hypertention,type 2 diabetes,hyperuricemia,hyperhomocysteinemia,freezing of gait(FOG),rapid eye movement sleep behavior disorder(RBD),hallucinations,Hoehn and Yahr(H-Y)scales,Unified PD Rating scale(UPDRS)-II,UPDRS-III,motor subtypes(TD,IN,PIGD),Hamilton depression scale(HAMD)and orthostatic hypotension were collected.Spss21.0 was used for statistical analysis of the data,to analyze the influencing factors of PD cognitive impairment and their internal correlation,and to analyze the characteristics of cognitive impairment.Results:140 PD patients were registered,25 PD patients were excluded,and finally 115 PD patients were enrolled.Univariate analysis showed that age,level of education,hypertention,FOG,UPDRS-II,UPDRS-III,H-Y scales,motor subtypes were the influencing factors of cognitive impairment in PD,multivariate logistic regression analysis showed that age,level of education,FOG,UPDRS-III were the independent influencing factors of cognitive impairment in PD.Cognitive impairment in PD was positively correlated with age,FOG,and UPDRS-III,and negatively correlated with level of education.Spearman correlation analysis showed that FOG and UPDRS-II,UPDRS-III,motor subtypes was a positive correlation.The proportion of each damaged MoCA subtest in 27 cases of cognitive impairment patients with PD accompanied by FOG was counted,impaired memory(delayed recall)accounted for 100%,impaired language 85.20%,impaired abstraction 81.5%,impaired executive function 77.80%,impaired visuospatial function 74.10%,impaired attention 63.00%,impaired naming 59.30%,impaired orientation 44.40%.Conclusions:The results of this study indicated that age,FOG,and UPDRS-? were the risk factors for cognitive impairment of PD,and the level of education was the protective factor.In addition,the occurrence of FOG in PD patients could increase the UPDRS-? and UPDRS-? scores,and increase the possibility of PIGD type.The MoCA subtests most commonly involved in PD patients with cognitive impairment accompanied by FOG were memory(delayed recall),language,abstraction,executive function,visuospatial function,attention,naming,orientation.