Objective: To analyze probability of prodromal Parkinson's disease (pPD) and assess the association between global cognitive function and cognitive domain function and probability of pPD in ≥55 years old middle-aged and elderly people in Hebei, Zhejiang, Shaanxi and Hunan Provinces in China. Methods: Data were collected from dataset of the Community-based Cohort Study on Nervous System Disease 2020. We selected 4 634 Alzheimer disease and Parkinson's disease free persons aged ≥55 years with completed information on demographics, disease history, cognitive test, and risk factors of Parkinson's disease for this study. Cognitive function was assessed using Montreal Cognitive Assessment Scale (Chinese version). Calculation of probability of pPD and assessment of possible/probable pPD were performed according to the criteria published by the International Parkinson and Movement Disorder Society. Multivariate linear regression model was used to analyze the association between cognitive function and probability of pPD. Results: The M (Q1,Q3) of global cognitive function and cognitive domains in terms of memory, execution, visuospatial function, language, attention and orientation were 25 (20, 30), 13 (11, 15), 10 (7, 12), 6 (4, 7), 5 (4, 6), 15 (12, 18) and 6 (6, 6) points, respectively. The M(Q1,Q3) of probability of pPD was 0.42% (0.80%, 1.73%), and the proportion of the study subjects with possible/probable pPD was 0.4%. Differences in the distribution of probability of pPD were significant among groups by total cognitive score quartiles (P<0.001), and the difference in proportions of study subjects with possible/probable pPD was significant and showed decline trend (P=0.001). After adjusted for confounders, the results of multivariate linear regression analyses showed that probability of pPD in the Q2, Q3 and Q4 group decreased by 23.4%, 31.2% and 20.1% compared with Q1 group, and corresponding β values were 0.766 (95%CI: 0.702-0.836), 0.688 (95%CI: 0.631-0.751) and 0.799 (95%CI: 0.730-0.875), respectively, the trend was significant (P<0.001). Higher index scores of execution, visuospatial function, language, attention and orientation were highly related to lower probability of pPD (P<0.001). Conclusion: Declines in global cognitive function and cognitive domains of execution, visuospatial function, language, attention and orientation might increase the probability of pPD in middle-aged and elderly people, suggesting the importance of cognitive intervention in early stage for pPD prevention.
目的： 分析我国河北省、浙江省、陕西省和湖南省（4省份）≥55岁中老年人帕金森病前驱期（pPD）患病概率，探讨总体认知功能及不同认知域功能与pPD患病概率的关联性。 方法： 利用神经系统疾病专病社区队列研究2020年调查数据，选择未患阿尔茨海默病和帕金森病的有完整人口统计学、疾病史、认知功能评估和帕金森病风险因素数据的≥55岁中老年人4 634人。采用蒙特利尔认知测验中文版量表评估认知功能，按照国际帕金森病及运动障碍协会诊断标准评估pPD患病概率并判定pPD，采用多因素线性回归模型分析认知功能与pPD患病概率的关联性。 结果： 研究对象总体认知功能评分、记忆、执行力、视空间、语言、注意力和定向指数评分的M（Q1，Q3）分别为25（20，30）、13（11，15）、10（7，12）、6（4，7）、5（4，6）、15（12，18）和6（6，6）分，pPD患病概率M（Q1，Q3）为0.42%（0.80%，1.73%），可能或极可能患pPD者比例为0.4%。总体认知功能评分四等分组pPD患病概率分布差异有统计学意义（P<0.001），可能或极可能pPD患者比例差异有统计学意义且呈下降趋势（P=0.001）。调整混杂因素后，多因素线性回归分析结果显示，总体认知功能评分Q2、Q3和Q4组pPD患病概率较Q1组分别降低23.4%、31.2%和20.1%，相应的β值（95%CI）分别为0.766（0.702~0.836）、0.688（0.631~0.751）和0.799（0.730~0.875），且趋势有统计学意义（P<0.001）。较高的执行力、视空间、语言、注意力和定向指数评分与较低的pPD患病概率有关，差异有统计学意义（均P<0.001）。 结论： 总体认知功能及执行力、视空间、语言、注意力和定向功能减退可能增加中老年人pPD患病概率，提示早期认知功能干预对预防pPD有重要意义。.