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J Neurol Neurosurg Psychiatry ; 84(8): 883-7, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23463867

RESUMEN

OBJECTIVE: To determine whether four key neuropsychiatric and sleep related features associated with Parkinson's disease (PD) are associated with the motor handicap and demographic data. BACKGROUND: The growing number of recognised non-motor features of PD makes routine screening of all these symptoms impractical. Here, we investigated the hypothesis that standard demographic data and the routine assessment of motor signs is associated with the presence of dementia, psychosis, clinically probable rapid eye movement (REM) sleep behavior disorder (cpRBD) and restless legs syndrome (RLS). METHODS: 775 patients with PD underwent standardised assessment of motor features and the presence of dementia, psychosis, cpRBD and RLS. A stepwise feature elimination procedure with fitted logistic regression models was applied to identify which/if any combination of demographic and motor factors is associated with each of the four studied non-motor features. A within-study out-of-sample estimate of the power of the predicted values of the models was calculated using standard evaluation procedures. RESULTS: Age and Hoehn&Yahr (H&Y) stage were strongly associated with the presence of dementia (p value<0.001 for both factors in the final selected model) while a combination of age, disease duration, H&Y stage, dopamine agonists and catechol-O-methyltransferase (COMT) inhibitors was associated with the presence of psychosis. Disease duration and H&Y stage were the significant indicators of cpRBD, and the lack of significant motor asymmetry was the only significant feature associated with RLS-type symptoms but the evidence of association was weak. CONCLUSIONS: Demographic and motor features routinely collected in patients with PD can estimate the occurrence of neuropsychiatric and sleep-related features of PD.


Asunto(s)
Trastornos Mentales/psicología , Trastornos del Movimiento/psicología , Enfermedad de Parkinson/psicología , Trastornos del Sueño-Vigilia/psicología , Anciano , Envejecimiento/psicología , Antiparkinsonianos/uso terapéutico , Catecol O-Metiltransferasa/sangre , Estudios Transversales , Demencia/etiología , Demencia/psicología , Agonistas de Dopamina/uso terapéutico , Femenino , Humanos , Modelos Logísticos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/etiología , Persona de Mediana Edad , Modelos Estadísticos , Movimiento/fisiología , Trastornos del Movimiento/epidemiología , Trastornos del Movimiento/fisiopatología , Examen Neurológico , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/epidemiología , Trastornos Psicóticos/etiología , Trastornos Psicóticos/psicología , Trastorno de la Conducta del Sueño REM/etiología , Trastorno de la Conducta del Sueño REM/psicología , Curva ROC , Síndrome de las Piernas Inquietas/etiología , Síndrome de las Piernas Inquietas/psicología , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/etiología , Factores Socioeconómicos
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