Title Kognitivna disfunkcija u bolesnika s Parkinsonovom bolesti u Splitsko-dalmatinskoj županiji
Title (english) Prevalence of cognitive impairment in patients with Parkinson’s disease in Split-Dalmatia County
Author Katarina Tomasović
Mentor Gordan Džamonja (mentor)
Committee member Meri Matijaca (predsjednik povjerenstva)
Committee member Maja Valić (član povjerenstva)
Committee member Renata Pecotić (član povjerenstva)
Granter University of Split School of Medicine (Neurology) Split
Defense date and country 2018, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Neurology
Abstract Cilj istraživanja: Cilj ovog istraživanja bio je prikazati učestalost kognitivne disfunkcije u bolesnika oboljelih od PB-a u Splitsko-dalmatinskoj županiji, ispitati utjecaj raznih čimbenika na kognitivni status te njegov utjecaj na kvalitetu života oboljelih od PB-a.
Ispitanici i metode: Ovo opisno presječno istraživanje provedeno je u Klinici za neurologiju KBC Split. U ispitivanje je uključeno 39 pacijenata s PB-om. Podatci su prikupljani u vremenu od listopada 2017. do svibnja 2018. godine. Ispitivanje smo započeli uvidom u medicinsku dokumentaciju gdje smo prikupili demografske i kliničke podatke o bolesnicima. Ispitanici su potom pregledani te anketirani uz pomoć za PB specifičnih upitnika: MoCA, Hoehn i Yahr skale, UPDRS, PDQ-39, skala dnevnih aktivnosti po Schwab i England-u. U statističkoj obradi podataka koristili smo Mann-Whitney U test, Shapiro-Wilk test i Pearsonov koeficijent korelacije.
Rezultati: Od ukupnog broja pacijenata koji su učestvovali u istraživanju većina je na MoCA testu ostvarila rezultat manji od 26 bodova (66,67%), što ukazuje na blagi kognitivni poremećaj i/ili demenciju. Između muškaraca i žena nismo ustanovili statistički značajnu razliku u rezultatima MoCA upitnika. Životna dob se pokazala kao rizični faktor za razvoj kognitivne disfunkcije, dok to nismo dokazali za duljinu trajanja bolesti. Našli smo statistički značajnu razliku rezultata u domenama vizuospacijalnih/izvršnih sposobnosti, pažnje, jezika, apstraktnog mišljenja i odgođenog prisjećanja kod bolesnika s kognitivnom disfunkcijom (MoCA<26) u usporedbi s pacijentima s normalnom kognicijom. Ustanovili smo povezanost rezultata MoCA upitnika sa stadijem bolesti po Hoehn i Yahr-u. Bolesnici teškog stadija bolesti ostvarili su najlošije rezultate. Ustanovili smo i povezanost rezultata MoCA upitnika s UPDRS ljestvicom. Progresijom motoričkih simptoma bolesti i posljedično duljim korištenjem levodope opada kognitivna sposobnost bolesnika s PB-om. Ustanovili smo i značajnu korelaciju kvalitete života s testovima kognitivne procjene.
Zaključak: Kognitivna disfunkcija u rasponu od blagog kognitivnog poremećaja do demencije je učestali simptom oboljelih od PB-a. Najčešće su zahvaćene domene vizuospacijalnih/izvršnih sposobnosti, pažnje, jezika, apstraktnog mišljenja i odgođenog prisjećanja. S porastom životne dobi bolesnika s PB-om dolazi do progresije kognitivnog deficita, dok utjecaj spola i duljina trajanja bolesti nije dokazana. Bolesnici teškog stadija bolesti ostvarili su najlošije rezultate na MoCA upitniku. Kognitivne funkcije znatno utječu na kvalitetu života oboljelih.
Abstract (english) Objectives: The aim of this study was to review the prevalence of cognitive impairment in patients with Parkinson′s disease (PD) in Split-Dalmatia County, to investigate effects of other variables on the cognitive status and its impact on the patients’ quality of life.
Subjects and methods: This descriptive cross-sectional study was conducted at the Department of Neurology. The study included 39 patients suffering from PD. The data was collected in the period from October 2017, ending in May 2018. We started the examination with an insight into the medical documentation where the demographic and medical information about our subjects were collected. Subjects were than examined and asked to fill out PD specific questionnaires: MoCA, Hoeh and Yahr scale, UPDRS, PDQ-39, daily activity scales by Schwab and England. In order to analyze the given variables we used Mann-Whitney U test, Shapiro-Wilk test, and the Pearson coefficient of correlation.
Results: Most of the patients who participated in the research scored less than 26 points on the MoCA questionnaire, which indicates a mild cognitive impairment and/or dementia. There hasn’t been found a statistically significant difference among men and women in the results of the MoCA questionnaire. Age has proven to be a risk factor for the development of cognitive dysfunctions. The duration of the disease did not affect the cognition test results. The MoCA questionnaire domains of visuospatial/executive abilities, attention, language, abstract thinking, and delayed recall showed statistically significant difference in outcome between patients with cognitive impairment (MoCA<26) and with normal cognition. A connection was established between results of the MoCA questionnaire and the stage of disease by Hoehn and Yahr. Patients in the severe stage of disease achieved the worst results. A correlation was also established between the MoCA questionnaire results and the UPDRS scale that tracks the development of the disease symptoms. As a result of the progression of motor symptoms of the disease and a consequently higher average of the use of levodopa, the cognitive ability of patients with PD is in decline. A correlation was also found between the quality of life and cognitive assessment tests. Individuals with a better quality of life performed better results on cognitive assessment tests.
Conclusions: Cognitive dysfunction in the range of mild cognitive impairment to dementia is common symptom of PD patients. A common symptoms in PD patients are cognitive deficit, specifically in the domains of the visuospatial/executive abilities, attention, language, abstract thinking and delayed recall. The age of patient during the diagnosis of the disease and at the time of the survey has a negative impact on cognitive abilities, whereas sex and length of the disease do not affect cognitive abilities. Patients in the severe stage of disease achieved the worst results on the MoCA questionnaire. Cognitive functions affect the patient’s quality of life to a great extent.
Keywords
Parkinsonova bolest
Kognitivna disfunkcija
Keywords (english)
Parkinson Disease
Cognitive Dysfunction
Language croatian
URN:NBN urn:nbn:hr:171:120277
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2018-11-23 08:20:23