帕金森病并发淡漠的危险因素研究

doi:10.3969/j.issn.1006-9771.2021.06.014

Abstract

Abstract: Objective

To study the prevalence and related factors of apathy in patients with Parkinson's disease (PD)．

Methods

From November, 2017 to December, 2019, 254 PD patients in our hospital were included. According to Starkstein Apathy Scale (SAS), they were divided into apathy group and non-apathy group. Clinical data such as demographic data, motor symptoms, non-motor symptoms and motor complications were collected for comparison between two groups. Logistic regression analysis was performed to investigate the risk factors of apathy in PD.

Results

Among 254 PD patients, 124 (48.8%) cases were in apathy. Compared with non-apathy group, apathy group was older in age and age of onset, higher in the scores of Movement Disorder Society United Parkinson's Disease Rating Scale part III (MDS-UPDRS Ⅲ), Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Pittsburgh Sleep Quality Index (PSQI) (t > 2.291, P < 0.05), and lower in the scores of Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) (t > 22.424, P < 0.001). There was no statistically significant difference in gender, time of education, body mass index (BMI), disease course, Hoehn-Yahr (H-Y) stage, wearing-off phenomenon, dyskinesia, on-and-off phenomenon, and the scores of Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDQ) and Epworth Sleeping Scale (ESS) between two groups (P > 0.05). Logistic regression analysis showed that the age of disease onset, MoCA and HAMD scores were correlated with apathy in patients with PD (P < 0.05).

Conclusion

The presence of apathy in PD may be associated with older age of disease onset, severity of depression and cognitive impairment.

Key words: Parkinson's disease, apathy, depression, cognition impairment

CLC Number:

R742.5

Xin LIU,Zhi-ke YIN,Tao FENG,Yong-mei DENG,Yue-ying ZHAO,Ke DONG,Chun-xue WANG,Hui-zi MA. Risk Factors of Apathy in Parkinson's Disease[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(6): 719-723.

Figures/Tables 4

References 29

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项目	非淡漠组 (n = 130)	淡漠组 (n = 124)	t/χ²/U值	P值
年龄(岁)	63(54.75,69.25)	65(62,71)	8.262	0.004
性别(男/女，n)	76/54	68/56	0.339	0.560
受教育时间(年)	9(6,12.25)	9(6,12)	0.727	0.395
BMI (kg/m²)	24.21±3.34	23.73±3.47	1.119	0.264
发病年龄(岁)	55.73±11.59	59.73±9.75	-2.983	0.003
病程(年)	5(2,8)	4.5(2,8)	0.159	0.690

项目	非淡漠组 (n = 130)	淡漠组 (n = 124)	t/χ²值	P值
MDS-UPDRS Ⅲ评分	37.6±15.9	43.6±18.0	-2.822	0.005
H-Y分期(早期/中晚期，n)	69/61	53/71	2.716	0.099
剂末现象(有/无，n)	37/93	46/78	2.151	0.142
异动症(有/无，n)	16/114	19/105	0.486	0.486
开关现象(有/无，n)	11/119	14/110	0.572	0.449

项目	非淡漠组 (n = 130)	淡漠组 (n = 124)	U值	P值
MoCA评分	23(18,26.25)	19(13,23)	28.466	< 0.001
MMSE评分	27(24,29)	25(20,27)	22.242	< 0.001
HAMD评分	8(4,13)	14(6.25,21)	21.586	< 0.001
HAMA评分	8(5,14)	13(8,19)	18.081	< 0.001
RBDSQ评分	3(1,6)	2(1,6)	0.219	0.640
PSQI评分	8.50±5.02	10.02±4.89	-2.291	0.023
ESS评分	4(2,7)	4(1,9)	0.992	0.320

自变量	β	SE	Wald	P值	Exp(B)	95%CI
起病年龄	0.030	0.014	4.411	0.036	1.030	1.002~1.059
女	-0.267	0.303	0.774	0.379	0.766	0.423~1.387
MDS-UPDRS Ⅲ评分	0.013	0.010	1.687	0.194	1.013	0.994~1.033
MoCA评分	-0.074	0.027	7.367	0.007	0.928	0.880~0.980
HAMD评分	0.042	0.019	5.177	0.023	1.043	1.006~1.082
PSQI评分	0.017	0.032	0.267	0.606	1.017	0.955~1.082

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Risk Factors of Apathy in Parkinson's Disease

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