認知症リスクの増大に
関連しない事が
分かったとあります。
スコアにあったような・・・。
認知症発症の独立危険因子が
幾つかあげられていますが、
その中に、
「レボドパの高用量」
の記述があります。
Hoehn & Yahr stageとの
関連も考慮しないと
いけないでしょうが、
考えなければなりません。
SCOPA-Cogとは、
Scales for Outcomes
in Parkinson's
Disease-Cognitionのこと。
Predictors
of dementia
in
in
Parkinson's disease;
findings from
findings from
a 5-year
prospective study
using
using
the SCOPA-COG
Kangdi Zhu,
van Hilten,
Johan Marinus
Department of Neurology,
Leiden University
Medical Center, Leiden,
The Netherlands
Parkinsonism Relat Disord.
2014 Sep;20(9):980-5.
doi: 10.1016/
j.parkreldis.2014.06.006.
Aim of this study
was to identify risk factors
for the development
of dementia in patients
with Parkinson's disease (PD).
Methods
A broad range
of motor
and non-motor features
was assessed
at baseline
and the following five years
in 406 PD patients.
Cross-sectional analyses
of baseline data
and longitudinal analyses
of follow-up data
were performed
to identify
risk factors for dementia.
Results
Thirty-two percent
of patients (n = 129)
had dementia at baseline,
while 26%
of patients (n = 68)
without dementia
at baseline
developed dementia
during follow-up.
Univariate survival analysis
showed that
higher age,
fewer years of education,
longer disease duration,
higher age-at-onset,
higher levodopa dose,
higher Hoehn & Yahr stage,
presence of dyskinesias,
excessive daytime sleepiness
(EDS), presence of hallucinations,
and more severe autonomic
and depressive symptoms
were associated
with an increased risk
of dementia.
Higher baseline
Postural-Instability-
and-Gait-Difficulty scores
were also associated
with an increased risk
of dementia, whereas
no effect
of tremor severity was found.
These findings
largely corresponded
with the variables
that were associated
with the presence
of dementia at baseline.
In a stepwise regression model,
higher age at baseline,
fewer years of education,
higher daily levodopa dose
and
excessive daytime sleepiness
(EDS) emerged
as independent risk factors
of future dementia.
Conclusions
In this large
Kangdi Zhu,
van Hilten,
Johan Marinus
Department of Neurology,
Leiden University
Medical Center, Leiden,
The Netherlands
Parkinsonism Relat Disord.
2014 Sep;20(9):980-5.
doi: 10.1016/
j.parkreldis.2014.06.006.
Aim of this study
was to identify risk factors
for the development
of dementia in patients
with Parkinson's disease (PD).
Methods
A broad range
of motor
and non-motor features
was assessed
at baseline
and the following five years
in 406 PD patients.
Cross-sectional analyses
of baseline data
and longitudinal analyses
of follow-up data
were performed
to identify
risk factors for dementia.
Results
Thirty-two percent
of patients (n = 129)
had dementia at baseline,
while 26%
of patients (n = 68)
without dementia
at baseline
developed dementia
during follow-up.
Univariate survival analysis
showed that
higher age,
fewer years of education,
longer disease duration,
higher age-at-onset,
higher levodopa dose,
higher Hoehn & Yahr stage,
presence of dyskinesias,
excessive daytime sleepiness
(EDS), presence of hallucinations,
and more severe autonomic
and depressive symptoms
were associated
with an increased risk
of dementia.
Higher baseline
Postural-Instability-
and-Gait-Difficulty scores
were also associated
with an increased risk
of dementia, whereas
no effect
of tremor severity was found.
These findings
largely corresponded
with the variables
that were associated
with the presence
of dementia at baseline.
In a stepwise regression model,
higher age at baseline,
fewer years of education,
higher daily levodopa dose
and
excessive daytime sleepiness
(EDS) emerged
as independent risk factors
of future dementia.
Conclusions
In this large
prospective cohort study,
we identified
a combination
of potentially
interacting risk factors
for dementia in PD
that are associated
with higher age
and more advanced disease.
以下はオマケ。
[Psychometric attributes
of Scales for Outcomes
in Parkinson's Disease-Cognition
(SCOPA-Cog), Castilian language].
Authors
Martínez-Martín P1,
Frades-Payo B,
Rodríguez-Blázquez C,
Forjaz MJ,
de Pedro-Cuesta J,
Grupo Estudio Longitudinal
de Pacientes con Enfermedad
de Parkinson.
Author information
1Centro Nacional
de Epidemiologia.
Instituto de Salud Carlos III,
28029 Madrid, España.
Journal
Rev Neurol.
2008 Oct 1-15;47(7):337-43.
Article in Spanish.
Abstract
AIM:
To test the psychometric attributes
of the Scales for Outcomes
in Parkinson's Disease-Cognition
(SCOPA-Cog),
we identified
a combination
of potentially
interacting risk factors
for dementia in PD
that are associated
with higher age
and more advanced disease.
以下はオマケ。
[Psychometric attributes
of Scales for Outcomes
in Parkinson's Disease-Cognition
(SCOPA-Cog), Castilian language].
Authors
Martínez-Martín P1,
Frades-Payo B,
Rodríguez-Blázquez C,
Forjaz MJ,
de Pedro-Cuesta J,
Grupo Estudio Longitudinal
de Pacientes con Enfermedad
de Parkinson.
Author information
1Centro Nacional
de Epidemiologia.
Instituto de Salud Carlos III,
28029 Madrid, España.
Journal
Rev Neurol.
2008 Oct 1-15;47(7):337-43.
Article in Spanish.
Abstract
AIM:
To test the psychometric attributes
of the Scales for Outcomes
in Parkinson's Disease-Cognition
(SCOPA-Cog),
in Castilian language.
PATIENTS AND METHODS:
It is a multicenter,
cross-sectional study
carried out
on 387 Parkinson's disease
PATIENTS AND METHODS:
It is a multicenter,
cross-sectional study
carried out
on 387 Parkinson's disease
(PD) patients.
They were
70% in Hoehn and Yahr
They were
70% in Hoehn and Yahr
stages 2 or 3;
their mean age was 65,8 years
and they underwent
their mean age was 65,8 years
and they underwent
the disease for 8,1 years.
Rater-based -SCOPA-Motor,
modified
Rater-based -SCOPA-Motor,
modified
Parkinson's
Psychosis Rating Scale,
Clinical Impression
Clinical Impression
of Severity Index for PD
(CISI-PD),
Cumulative Illness Rating Scale-Geriatrics-
and self-administered
Cumulative Illness Rating Scale-Geriatrics-
and self-administered
-SCOPA-Autonomic,
SCOPA-Sleep,
SCOPA-Psychosocial,
Hospital Anxiety
SCOPA-Sleep,
SCOPA-Psychosocial,
Hospital Anxiety
and Depression Scale,
EuroQoL- assessments
EuroQoL- assessments
were applied.
For SCOPA-Cog,
the following
For SCOPA-Cog,
the following
psychometric attributes
were analysed:
acceptability,
internal consistency,
dimensionality,
construct validity,
and precision.
A cut-off point for dementia
and SCOPA-Cog
were analysed:
acceptability,
internal consistency,
dimensionality,
construct validity,
and precision.
A cut-off point for dementia
and SCOPA-Cog
score's predictors
were explored.
RESULTS:
SCOPA-Cog was
free from floor
were explored.
RESULTS:
SCOPA-Cog was
free from floor
and ceiling effect.
The internal consistency
was satisfactory (alpha = 0,83)
and the item-total correlation
The internal consistency
was satisfactory (alpha = 0,83)
and the item-total correlation
resulted
equal or upper than 0,45.
Two factors were identified
(52% of variance),
one of them formed by 3
out of the 4 memory-related items.
The correlation
equal or upper than 0,45.
Two factors were identified
(52% of variance),
one of them formed by 3
out of the 4 memory-related items.
The correlation
with other measures
was weak (rS < 0,35),
except for
the CISI-PD's item
was weak (rS < 0,35),
except for
the CISI-PD's item
'cognitive state'
(rS = 0,51).
SCOPA-Cog scored
significantly different
for Hoehn and Yahr stages
and for patients grouped
by age, age
at onset of PD, and education.
The standard error
of measurement
was 3,02.
A cut-off point 19/20
reached 76% sensitivity
and specificity for dementia.
Age and age at onset of PD
resulted the strongest predictors.
CONCLUSION:
SCOPA-Cog is
a consistent, valid,
and precise measure
for assessment
of the cognitive disorder in PD.
(rS = 0,51).
SCOPA-Cog scored
significantly different
for Hoehn and Yahr stages
and for patients grouped
by age, age
at onset of PD, and education.
The standard error
of measurement
was 3,02.
A cut-off point 19/20
reached 76% sensitivity
and specificity for dementia.
Age and age at onset of PD
resulted the strongest predictors.
CONCLUSION:
SCOPA-Cog is
a consistent, valid,
and precise measure
for assessment
of the cognitive disorder in PD.