Risk factors and prediction model of cognitive impairment in Parkinson's disease patients with RBD
Objective To explore the risk factors of cognitive impairment in Parkinson's disease(PD)patients with rapid eye movement sleep behavior disorder(RBD),and to construct a predictive model.Methods A total of 236 patients with RBD PD admitted to the Department of Neurology,the Third People's Hospital of Fuyang City from June 2020 to November 2023 were selected as the research objects.According to whether they were complicated with cognitive dysfunction,they were divided into cognitive impairment group and non-cognitive impairment group.The general information questionnaire,Montreal Cognitive Assessment(MoCA),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale 17(HAMD-17),Movement disorder society's unified PD rating scale Ⅱ,Ⅲ(MDS-UPDRS Ⅱ,MDS-UPDRS Ⅲ),Hoehn Yahr(H-Y)classification and laboratory examination indicators were used for evaluation.Univariate and Logistic multivariate regression analysis were used to analyze the factors affecting cognitive impairment in patients with PD with RBD,and a prediction model was constructed to evaluate its predictive efficacy.Results The MoCA score of 236 patients with PD with RBD was(20.49±4.06)points,including 175 cases(74.15％)with＜26 points and 61 cases(25.85％)with ≥ 26 points.Univariate analysis showed that age,education level,agricultural work,course of disease,H-Y grade,MDS-UPDRS Ⅱ score,MDS-UPDRS Ⅲ score,HAMD-17 score,free thyroxine(FT4),high-sensitive c-reactive protein(hs-CRP)may be the influencing factors of cognitive impairment in patients with PD with RBD(all P＜0.05).Logistic regression analysis showed that agricultural work,MDS-UPDRS Ⅱ score,MDS-UPDRS Ⅲ score,HAMD-17 score,FT4 and hs-CRP were the risk factors(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of Logistic regression model for predicting cognitive impairment in patients with PD with RBD was 0.966,95％CI was 0.945-0.987,P＜0.001,sensitivity was 90.86％,specificity was 93.44％.Conclusion Engaged in agricultural work,MDS-UPDRS Ⅱ score,MDS-UPDRS Ⅲ score,HAMD-17 score,FT4 and hs-CRP are all influencing factors affecting cognitive impairment in patients with PD with RBD,and the prediction model constructed accordingly has good predictive value,which can provide a basis for clinical formulation of prevention and treatment programs.
Rapid eye movement sleep behavior disorderParkinson diseaceCognitive impairmentHigh risk factorsPrediction model
NETL
NSTL
万方数据
