Table 3.
Predictors of dementia in Parkinson’s disease within 10 years
| Clinical model | Univariate | Multivariable | |||
|---|---|---|---|---|---|
| Phenotype, at baseline | Observed range | HR (95% CI) | P-value | HR (95% CI) | P-value |
| Age | 39.7–90.0 years | 1.07 (1.04–1.10) | <0.001* | 1.05 (1.01–1.09) | 0.014 |
| Years of education | 6–30 years | 0.9 (0.8–1.0) | 0.019* | ||
| Smoker | Ever versus never | 0.9 (0.5–1.6) | 0.740 | ||
| MADRS score | 0–18 | 1.0 (1.0–1.1) | 0.147 | ||
| Sex | Male versus female | 1.1 (0.6–1.7) | 0.820 | ||
| H&Y stage | 1.0–5.0 | 2.0 (1.4–2.8) | <0.001* | ||
| UPDRS total score | 8–81 | 1.0 (1.0–1.1) | <0.001* | ||
| UPDRS III subscore | 5–62 | 1.0 (1.0–1.1) | <0.001* | 1.0 (1.0–1.1) | 0.004 |
| PIGD score | 0–2.4 | 3.2 (1.8–5.7) | <0.001* | ||
| Tremor score | 0–1.5 | 0.6 (0.3–1.3) | 0.220 | ||
| Blink frequency | 0–80 per minute | 1.0 (1.0–1.0) | 0.029* | ||
| Slow saccades | Yes versus no | 1.2 (0.6–2.3) | 0.463 | ||
| Postural instability first year | Yes versus no | 4.6 (2.2–9.7) | <0.001* | ||
| Symmetrical onset | Yes versus no | 2.3 (2.2–3.9) | 0.003* | ||
| MCI | Yes versus no | 4.5 (2.7–7.6) | <0.001* | 4.2 (2.2–7.7) | <0.001 |
| Olfactory function | 0–12 correct | 0.8 (0.7–0.9) | <0.001* | 0.8 (0.7–0.9) | <0.001 |
| Alcohol use | Yes versus no | 0.5 (0.3–0.9) | 0.014* | ||
| Orthostatic blood pressure drop | −22 to 107 mmHg | 1.0 (1.0–1.0) | 0.006* | ||
| Biomarkers, at baseline | Biomarker model | ||||
| BMI | 19.2–36.5 | 1.1 (1.0–1.2) | 0.035 | ||
| APOE ɛ4 genotype | 0–2 ɛ4 alleles | 1.0 (0.6–1.6) | 0.851 | ||
| MAPT haplotype | H1/H2 | 1.0 (0.6–1.8) | 0.923 | ||
| CSF NfL (pg/ml) | 271–8700 | 1.0 (1.0–1.0) | <0.001* | ||
| CSF Aβ42 (pg/ml) | 249–1373 | 1.0 (1.0–1.0) | <0.001* | ||
| CSF NfL to Aβ42 ratio | 0.4–10.7 | 1.3 (1.2–1.7) | <0.001* | 1.5 (1.2–1.7) | <0.001 |
| CSF α-synuclein (pg/ml) | 0.3–2.2 | 1.1 (0–1.0) | 0.762 | ||
| B-TSH | 0.1–10.0 | 0.9 (0.7–1.2) | 0.538 | ||
| B-leucocytes | 4.0–11.2 | 1.0 (1.0–1.1) | 0.076 | ||
| B-B12 vitamin | 147–1475 | 1.0 (1.0–1.0) | 0.157 | ||
| B-folate | 6.1–54.0 | 1.0 (1.0–1.0) | 0.073 | ||
| DAT uptake, putamen | −5.2 to −0.4 SD | 0.79 (0.56–1.11) | 0.179 | ||
| DAT uptake, most affected caudate | −4.7 to 0.1 SD | 0.65 (0.50–0.85) | 0.002* | 0.59 (0.39–0.90) | 0.014 |
Hazard ratio (HR) for the risk of developing dementia (PDD) among 143 patients with Parkinson disease, within 10 years. In the multivariable model, only factors that were significant when corrected for age and sex and that were not excluded because of intercorrelation were retained. APOE genotype was investigated by the number of ɛ4 alleles. Eye movement saccades were assessed clinically. Olfactory function was measured by the number of correct answers on the 12-item brief smell inventory test (BSIT).
The variable was significant after the Benjamini–Hochberg correction for false discovery rate, with α = 0.05. MCI, mild cognitive impairment; B, measured in blood; SDs, standard deviations.