帕金森病的预后:鹿特丹一项关于痴呆和死亡风险的研究

作     者：De Lau L.M.L. Schipper C.M.A. Hofman A. M.M.B Breteler 高中宝 

作者机构：Dr. Department of Epidemiology and Biostatistics Erasmus Medical Center PO Box 1738 3000 DR Rotterdam Netherlands 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第12期

页      面：13-14页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：帕金森病 死亡风险 医疗记录 病例发现 队列研究 载脂蛋白 相对风险 回归分析法 无痴 检查和 

摘      要：Background: Most prognostic studies on Parkinson disease have been hospital based or have applied register-based casefinding methods. Potential under-representation of mild cases may have given biased results. Abstract:Objective: To evaluate whether Parkinson disease is associated with an increased risk of dementia and death. Design: Population-based cohort study. Parkinson disease and dementia were assessed through in-per-son examination at baseline (1990-1993) and 2 follow-up visits (1993-1994 and 1997-1999). Computerized linkage to medical and municipality records provided additional information on disease outcomes and mortality. Setting: General population. Participants: A total of 6969 participants, including 99 prevalent and 67 incident cases of Parkinson disease. Main Outcome Measures: Incident dementia and death. Adjusted hazard ratios were calculated through Cox proportional hazards regression analysis. Results: Patients with Parkinson disease had an increased risk of dementia (hazard ratio, 2.8; 95%confidence interval, 1.8-4.4), which was especially pronounced in participants carrying at least 1 apolipoprotein E gene (APOE) 2 allele (13.5; 4.5-40.6). Parkinson disease was associated with an increased mortality risk (1.8; 1.5-2.3). The association consistently diminished when analyses were sequentially restricted to patients with shorter disease duration and after adjustment for the occurrence of dementia. Conclusions: Especially patients with Parkinson disease who carry an APOE 2 allele have an increased risk of developing dementia. Increased mortality risk in Parkinson disease is dependent on disease duration and is only modest in the absence of dementia.