한빛사논문
- 조회512
Young-gun Lee, MD, PhD1,2, Mincheol Park, MD3, Seong Ho Jeong, MD4, Kyoungwon Baik, MD1, SUNGWOO KANG, MD1, So Hoon Yoon, MD1, Han Kyu Na, MD1, Young H. Sohn, MD, PhD1 and Phil Hyu Lee, MD, PhD1,5,a
1Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
2Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
3Department of Neurology, Chung-Ang University College of Medicine and Graduate School of medicine, Gwangmyeong Hospital, Gwangmyeong, South Korea
4Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
5Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
aCorresponding Author: Phil Hyu Lee
Abstract
Background and objectives: Neuropsychiatric symptoms (NPS) are closely associated with cognitive decline in patients with Parkinson's disease (PD). We investigated which profiles of NPS are associated with the risk of dementia in PD with mild cognitive impairment (PD-MCI).
Methods: We retrospectively assessed 338 patients with PD-MCI from a single tertiary hospital, who underwent neuropsychological tests and a neuropsychiatric inventory (NPI) questionnaire. We conducted a factor analysis of the dichotomized presence of 12 NPI symptoms, yielding three NPI factors: factor 1, mood symptoms; factor 2, hyperactivity-related symptoms; and factor 3, psychotic symptoms. Factor analysis of the severity of NPI symptoms also identified similar NPI factors. The neuropsychiatric correlates of NPI factors were evaluated using general linear models for cognitive tests. Subsequently, we evaluated the hazard ratio (HR) of NPI factors on conversion to dementia.
Results: A higher prevalence factor 1 score was associated with lower scores in the verbal memory (β = -0.15; 95% confidence interval [CI] = -0.24 - -0.06; p = 0.001) and executive domains (β = -0.16; 95% CI = -0.28 - -0.04; p = 0.007), whereas higher severity factor 2 scores were associated with lower scores in the naming (β = -0.16; 95% CI = -0.28 - -0.03; p = 0.012), visuospatial (β = -0.24; 95% CI = -0.41 - -0.07; p = 0.005), and verbal memory domains (β = -0.15; 95% CI = -0.24 - -0.05; p = 0.005). A higher severity factor 3 score was associated with lower scores in the visuospatial domain (β = -0.25; 95% CI = -0.46 - -0.07; p = 0.007). Cox regression models demonstrated that the risk of dementia was increased in those with higher prevalence factor 1 (HR = 1.48, 95% CI = 1.17 - 1.88, p = 0.001) and factor 2 scores (HR = 1.27, 95% CI = 1.07 - 1.51, p = 0.007) and severity factor 3 score (HR = 1.52, 95% CI = 1.29 - 1.80, p < 0.001) after adjusting for age, sex, education, disease duration, scores for cognition and parkinsonism, and levodopa equivalent dose.
Discussion: This study demonstrated that a higher burden of NPS is associated with dementia conversion in patients with PD-MCI.
논문정보
- Research article
- 2023년 07월 (BRIC 등록일 2023-09-07)
- 국내 연구진
- 의약학 > 신경의학
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