Anticholinergic Medication Burden and Cognitive Subtypes in Parkinson's Disease without Dementia.

IF 2.1 4区心理学 Q2 PSYCHOLOGY Archives of Clinical Neuropsychology Pub Date : 2024-11-22 DOI:10.1093/arclin/acae041

Lauren G Santos, Lauren E Kenney, Alyssa Ray, Alfredo Paredes, Adrianna M Ratajska, Kara Eversole, Bhavana Patel, Ashley E Rawls, Michael S Okun, Dawn Bowers

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Abstract

Objective: Cognitive changes are heterogeneous in Parkinson's disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes.

Method: A retrospective chart review contained participants (n = 493) who had idiopathic PD without dementia. Participants' medications were scored (0-3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS' relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test.

Results: Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e., score ≥3), no significant phenotype or domain differences were found.

Conclusions: Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia.

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无痴呆症帕金森病患者的抗胆碱能药物负担和认知亚型。

目的：帕金森病（PD）患者的认知变化多种多样。本研究比较了抗胆碱能负荷是否会导致认知领域表现的差异以及根据经验得出的帕金森病认知表型：一项回顾性病历审查包含了患有特发性帕金森病且无痴呆症的参与者（n = 493）。根据抗胆碱能认知负担量表（ACBS）对参与者的用药情况进行评分（0-3分）和加总。我们研究了 ACBS 与五个认知领域复合体（常模 Z 值）和三种认知表型（基于 K-均值聚类）之间的关系：认知完好、执行功能（EF）低下和 EF/记忆力严重受损。分析包括斯皮尔曼相关性、协方差分析和皮尔逊卡方检验：结果：总体而言，表型在抗胆碱能负荷方面没有差异，而且（经过误诊率校正后）没有认知领域相关。在比较高于和低于 ACBS 临床相关临界值（即得分≥3）的患者时，没有发现明显的表型或领域差异：结论：抗胆碱能药物的使用并不会影响无痴呆的特发性帕金森病大样本患者的认知能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Clinical Neuropsychology 医学-心理学

CiteScore

4.60

自引率

7.70%

发文量

358

审稿时长

6-12 weeks

期刊介绍： The journal publishes original contributions dealing with psychological aspects of the etiology, diagnosis, and treatment of disorders arising out of dysfunction of the central nervous system. Archives of Clinical Neuropsychology will also consider manuscripts involving the established principles of the profession of neuropsychology: (a) delivery and evaluation of services, (b) ethical and legal issues, and (c) approaches to education and training. Preference will be given to empirical reports and key reviews. Brief research reports, case studies, and commentaries on published articles (not exceeding two printed pages) will also be considered. At the discretion of the editor, rebuttals to commentaries may be invited. Occasional papers of a theoretical nature will be considered.