Analysis Of Factors Related To Mild Cognitive Impairment In Parkinson's Disease And Its Impact On Quality Of Life

Objective:To analyze the clinical characteristics of patients with Parkinson's disease mild cognitive impairment(PD-MCI)in Chinese population,and to explore the related factors and the impact of PD-MCI patients on quality of life.Methods:Subjects with non-dementia PD who were inpatient or outpatient in the department of neurology of Northern Jiangsu People's Hospital from January 2018 to October 2019 were collected and registered.All PD patients taking anti-Parkinson's drugs were evaluated during the "ON" phase and all subjects had a stable response to anti-Parkinson's drugs and were not considered to require special treatment for the symptoms of the disease.Patients were divided into the PD with normal cognitive(PD-NC)group and the PD-MCI group according to the PD-MCI grade ? diagnostic criteria issued by the Movement disorder society(MDS)in 2012 and the Chinese version of Montreal Cognitive Assessment(MoCA)score.Collect patient's age,gender,education level,age of onset(early onset or late onset),duration,smoking and drinking history,hypertension,diabetes,serum homocysteine levels,serum uric acid levels,and UPDRS-? total score,UPDRS-? total score,H-Y grade,exercise classification(TD type,PIGD type and Mixed type),PDQL-39 total score,ADL,HAMD and HAMA.SPSS23.0 conducted statistical analysis on the data in order to analyze the clinical characteristics and related factors of PD-MCI,and analyze the influence of PD-MCI patients on the quality of life.Results:A total of 127 non-demented PD patients were enrolled,including 79 males and 48 females.The average age was 63.37±9.63 years,the average course of disease was 3.56±2.13 years,the average years of education was 8.26±3.84 years,the average UPDRS-? score was 25.80±13.32,the average H-Y rating was 2.15±0.92,and the average HAMA score was 5.96±4.06,The average HAMD score is 7.32±4.56,the average serum uric acid levels was 325.46±73.43?mol/L,the average serum homocysteine levels was 11.84±5.09?mol/L,the average UPDRS-? score is 12.09±6.66,and the average ADL score 41.98±13.49,with an average PDQL-39 score of 138.91±25.11.There were 69 subjects(54.33%)in the PD-NC group and 58 subjects(45.67%)in the PD-MCI group.Univariate analysis showed that there were significant differences between the PD-MCI group and the PD-NC group in terms of age,age of onset,years of education,total score of UPDRS-III,H-Y classification,motor classification,HAMA score,and serum homocysteine levels,which ware statistically significant(P<0.05).Multivariate Logistic regression analysis showed serum homocysteine levels(OR:1.116;95%CI:1.018-1.224;P=0.020),education levels(OR:0.742;95%CI:0.645-0.853;P<0.001),UPDRS-?(OR:1.036;95%CI:1.002-1.072;P=0.036)were independent influencing factors of PD-MCI.PD-MCI was positively correlated with serum homocysteine levels and total score of UPDRS-III,and negatively correlated with education level.In the evaluation of activities of daily living,the total score and average score of UPDRS-II and ADL in PD-MCI group was significantly higher than that in PD-NC group,while the total score and average score of PDQL-39 in PD-MCI group was significantly lower than that in PD-NC group.There was significant difference in UPDRS-?,ADL and PDQL-39 scores between PD-MCI group and PD-NC group.Conclusion:This study shows that serum homocysteine levels and UPDRS-III are independent risk factors for PD-MCI,while years of education are protective factors,indicating that PD patients with higher serum homocysteine level,more serious the movement disorder and lower level of education are at higher risk of cognitive impairment.In addition,PD-MCI has a poorer quality of life than PD-NC patients.Therefore,early prevention of MCI-related risk factors provides effective means to delay cognitive decline and improve the quality of life of patients with PD.