Clinical Characteristics Of Cognitive Dysfunction And Its Related Factors In Patients With Parkinson's Disease

Objective To investigate the clinical characteristics and its related factors of cognitive dysfunction in patients with Parkinson's disease(PD).Methods A total of 96 patients with idiopathic PD who were admitted in department of Neurology and Geriatrics of Peking University Shenzhen Hospital,from February 2017 to September 2019 were collected.Demographic and clinical information were collected.The MMSE scale and Mo CA scale were used to evaluate the cognitive function of PD patients.All patients were assessed with Hoehn-Yahr(H-Y)stage during the off-period.H-Y stage 2 and below are group 1(early stage),above 2 is group 2(middle and late stage).The cognitive scores were compared between the two groups.PD patients were divided into normal cognition and cognitive impairment according to the cognitive assessment.Univariate analysis and Logistic regression analysis were used to screen for protective factors or risk factors for cognitive dysfunction,and correlation analysis was used to study the linear correlation between cognitive scores and Hoehn-Yahr stages.Results The MMSE scale and Mo CA scale were used to evaluate the cognitive function of 96 PD patients.The incidence of cognitive impairment was 47.92% and 67.71%.The Mo CA scale was more sensitive to cognitive impairment(P<0.001).There was no difference in age,age of onset,gender,clinical onset symptoms,and years of educationbetween early stage and middle and late stage;group 2 had a longer course of disease(P<0.001).The total scores of the MMSE scale and Mo CA scale were different between the two groups(P=0.014,P=0.007),and the former showed differences in attention and calculation levels(P=0.016),while the latter showed differences in visuospatial and executive functions,naming,alertness,and abstraction(P<0.001,P=0.043,P=0.005,P=0.02).Univariate analysis of the assessment results of the MMSE scale revealed that years of education and H-Y groups were different(P<0.001,P=0.035),while age,age of onset,and years of education(P = 0.009,P = 0.010,P<0.001)affected Mo CA scale's results.Logistic regression analysis found that years of education is a protective factor of cognitive function(P<0.001)and H-Y groups is a risk factor for the Mo CA score(P=0.035,OR=1.829).Univariate analysis and multivariate analysis did not find that gender,age,age of onset,course of disease,and clinical onset symptoms could affect cognitive function.Correlation analysis found that there was a positive correlation between cognitive scores and years of education,and a negative correlation between cognitive scores and the combined Hoehn-Yahr stage.Conclusion Cognitive dysfunctions has a high incidence in PD.Cognitive screening with the Mo CA scale in clinical assessment is more appropriate for patients with PD.PD cognitive dysfunctions are mainly showed in visuospatial and executive functions,alertness.No cognitive differences caused by age,gender,and clinical onset symptoms were found.Years of education cannot be changed,and it is a protective factor for cognitive function.Hoehn-Yahr stage is related to the risk of cognitive impairment in the future.Early attention to the cognitive status of PD patients,including early screening,medication and cognitive interventions,can help improve cognition.