Relación entre el tiempo de evolución de la enfermedad de Parkinson y la aparición de alteraciones cognitivas en pacientes atendidos en el área de neurología del Hospital de Especialidades Teodoro Maldonado Carbo en el período de enero 2019 - diciembre 2022.

Abstract

Parkinson's disease (PD) is characterized by progressive loss of dopaminergic cells in the substantia nigra and depletion of dopamine in the striatum and presence of so- called Lewy bodies, leading to dysfunction in the corticostriatal networks that are essential for movement control, resulting in symptoms such as: resting tremor, bradykinesia, rigidity, postural instability (1,2). In addition to the typical motor symptoms already known, current studies are identifying PD as a heterogeneous multisystemic disorder that in turn involves other neurotransmitters, such as serotonin, noradrenaline, acetylcholine (2). For this reason, we can see a wide variety of non-motor symptoms, such as autonomic dysfunction, pain and cognitive impairment (2,3). Objective: To determine the relationship between the time of evolution of Parkinson's disease with the appearance of cognitive alterations in patients treated in the Neurology area of the Hospital Teodoro Maldonado Carbo in the period 2019-2022. Methodology: A cross- sectional study, descriptive and correlational analysis was carried out from 2019-2022 of all patients who attended the neurology department at the Teodoro Maldonado Carbo hospital in Guayaquil. Results: A total of 1157 patients diagnosed with Parkinson's disease were evaluated, of which 118 (10.2%) presented cognitive alterations. It was demonstrated that there is a statistically significant relationship between the time of PD evolution and the appearance of cognitive alterations interpreted with the MOCA TEST (p=0.000). In addition, 48.3% of the sample presented cognitive alterations within the first 5 years of evolution. Dementia has the highest prevalence with 35.6% of the total sample. It was also demonstrated that as more time elapsed since the initial diagnosis, an increase in the degree of cognitive impairment was observed in individuals affected by Parkinson's disease (p = 0.022), finally a negative association was observed between taking medication and the development of cognitive impairment. Conclusion: In the present study it was concluded that as the time of evolution of PD increases, the risk of presenting cognitive impairment increases significantly, but also that as time elapses from the initial diagnosis, an increase in the degree of cognitive impairment is observed in affected individuals.