Seok Jong Chung1,2, Hye Sun Lee3, Hang-Rai Kim4,5, Han Soo Yoo1, Yang Hyun Lee1, Jin Ho Jung1, KyoungWon Baik1, Byoung Seok Ye1, Young H Sohn1, Phil Hyu Lee6,7. 1. From the Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea (S.J. Chung, H.S. Yoo, Y.H. Lee, J.H. Jung, K.W. Baik, B.S. Ye, Y.H. Sohn, P.H. Lee). 2. Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea (S.J. Chung). 3. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea (H.S. Lee). 4. Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea (H.R. Kim). 5. KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea (H.R. Kim). 6. From the Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea (S.J. Chung, H.S. Yoo, Y.H. Lee, J.H. Jung, K.W. Baik, B.S. Ye, Y.H. Sohn, P.H. Lee); phlee@yuhs.ac. 7. Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea (P.H. Lee).
Abstract
OBJECTIVES: To investigate which baseline neuropsychological profile predicts the risk of developing dementia in early-stage Parkinson's disease (PD). METHODS: We retrospectively reviewed detailed medical records of 350 drug-naïve patients with early-stage PD (follow-up > 3 years), who underwent a detailed neuropsychological test at initial assessment. Factor analysis was conducted to determine cognitive profiles which yielded four cognitive function factors: Factor 1 (visual memory/visuospatial), Factor 2 (verbal memory), Factor 3 (frontal/executive), and Factor 4 (attention/working memory/language). Subsequently, we assessed the effect of these cognitive function factors on the risk for dementia conversion. We also constructed a nomogram to calculate the risk for developing dementia over a 5-year follow-up period based on these cognitive profiles. RESULTS: Cox regression analysis demonstrated that a higher composite score of Factor 1 (hazard ratio [HR], 0.558; 95% confidence interval [CI], 0.427-0.730), Factor 2 (HR, 0.768; 95% CI, 0.596-0.991), and Factor 3 (HR, 0.425; 95% CI, 0.305-0.593) was associated with a lower risk for dementia conversion, while Factor 3 had the most predictive power. The nomogram had a fair ability (Heagerty's integrated area under the curve, 0.763) to estimate the risk for dementia conversion within 5 years. The composite scores of Factor 3 contributed more to the occurrence of dementia in PD than those of the other cognitive function factors. CONCLUSIONS: These findings suggest that these factor analysis-derived cognitive profiles can be used to predict dementia conversion in early-stage PD. Additionally, frontal/executive dysfunction contributes most to the occurrence of dementia in PD.
OBJECTIVES: To investigate which baseline neuropsychological profile predicts the risk of developing dementia in early-stage Parkinson's disease (PD). METHODS: We retrospectively reviewed detailed medical records of 350 drug-naïve patients with early-stage PD (follow-up > 3 years), who underwent a detailed neuropsychological test at initial assessment. Factor analysis was conducted to determine cognitive profiles which yielded four cognitive function factors: Factor 1 (visual memory/visuospatial), Factor 2 (verbal memory), Factor 3 (frontal/executive), and Factor 4 (attention/working memory/language). Subsequently, we assessed the effect of these cognitive function factors on the risk for dementia conversion. We also constructed a nomogram to calculate the risk for developing dementia over a 5-year follow-up period based on these cognitive profiles. RESULTS: Cox regression analysis demonstrated that a higher composite score of Factor 1 (hazard ratio [HR], 0.558; 95% confidence interval [CI], 0.427-0.730), Factor 2 (HR, 0.768; 95% CI, 0.596-0.991), and Factor 3 (HR, 0.425; 95% CI, 0.305-0.593) was associated with a lower risk for dementia conversion, while Factor 3 had the most predictive power. The nomogram had a fair ability (Heagerty's integrated area under the curve, 0.763) to estimate the risk for dementia conversion within 5 years. The composite scores of Factor 3 contributed more to the occurrence of dementia in PD than those of the other cognitive function factors. CONCLUSIONS: These findings suggest that these factor analysis-derived cognitive profiles can be used to predict dementia conversion in early-stage PD. Additionally, frontal/executive dysfunction contributes most to the occurrence of dementia in PD.
Authors: Seok Jong Chung; Han Soo Yoo; Hye Sun Lee; Yang Hyun Lee; KyoungWon Baik; Jin Ho Jung; Byoung Seok Ye; Young H Sohn; Phil Hyu Lee Journal: J Neurol Date: 2021-05-04 Impact factor: 4.849
Authors: Dag Aarsland; Lucia Batzu; Glenda M Halliday; Gert J Geurtsen; Clive Ballard; K Ray Chaudhuri; Daniel Weintraub Journal: Nat Rev Dis Primers Date: 2021-07-01 Impact factor: 52.329