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Factor analysis-derived cognitive profile predicting early dementia conversion in PD

Authors
 Seok Jong Chung  ;  Hye Sun Lee  ;  Hang-Rai Kim  ;  Han Soo Yoo  ;  Yang Hyun Lee  ;  Jin Ho Jung  ;  KyoungWon Baik  ;  Byoung Seok Ye  ;  Young H Sohn  ;  Phil Hyu Lee 
Citation
 NEUROLOGY, Vol.95(12) : e1650-e1659, 2020-09 
Journal Title
NEUROLOGY
ISSN
 0028-3878 
Issue Date
2020-09
MeSH
Aged ; Dementia / diagnosis ; Dementia / etiology* ; Early Diagnosis* ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests* ; Nomograms ; Parkinson Disease / complications* ; Retrospective Studies ; Risk Factors
Abstract
Objectives: To investigate which baseline neuropsychological profile predicts the risk of developing dementia in early-stage Parkinson disease (PD).

Methods: We retrospectively reviewed detailed medical records of 350 drug-naive 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 that yielded 4 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 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. In addition, frontal/executive dysfunction contributes most to the occurrence of dementia in PD.
Full Text
https://n.neurology.org/content/95/12/e1650.long
DOI
10.1212/WNL.0000000000010347
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Baik, Kyoungwon(백경원) ORCID logo https://orcid.org/0000-0001-7215-375X
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Yoo, Han Soo(유한수) ORCID logo https://orcid.org/0000-0001-7846-6271
Lee, Yang Hyun(이양현)
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180060
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