Chinese Journal of Alzheimer's Disease and Related Disorders · Oct 23, 2026
Correlation analysis of autonomic function and cognitive function in Parkinson's disease
By 李茜瑜
OBJECTIVE: To evaluate the correlation between autonomic dysfunction and cognitive function in patients with Parkinson's disease (PD). METHODS: A total of 221 patients with PD who attended the movement disorders outpatient clinic at Tianjin Huanhu Hospital from 2023-1 to 2024-12 were included. All patients were assessed using the Scales for Outcomes in Parkinson's Disease–Autonomic Dysfunction (SCOPA-AUT) and were divided according to their SCOPA-AUT scores into a high autonomic symptom burden group (H-ANS,n=120) and a low autonomic symptom burden group (L-ANS,n=101). Pearson's chi-square test or the nonparametric Mann-Whitney U test was used to compare differences between the H-ANS and L-ANS groups. Spearman correlation analysis and multiple linear regression were used for statistical analysis. RESULTS: Compared with patients with PD in the L-ANS group, those in the H-ANS group were older (68.62±7.04 vs.64.67±7.74,P<0.01), had a longer disease duration (5.13±5.10 vs.3.94±3.10,P=0.043), and had a later age at onset (63.37±8.70 vs.60.57±7.82,P=0.013). Among patients with PD in the older age group (age >68 years), the H-ANS group had higher H&Y scores (3.0 vs.2.5,P<0.05), higher UPDRS-Ⅲ scores (36.5 vs.27.5,P<0.05), and lower MoCA scores (19 vs.20,P=0.047) than the L-ANS group. Among patients with PD in the younger age group (age ≤68 years), the H-ANS group had higher H&Y scores (2.5 vs.2.0,P<0.05) and higher UPDRS-Ⅲ scores (36.5 vs.25.0,P<0.05) than the L-ANS group, but cognitive scores did not differ significantly between the two groups (P>0.05). The total Montreal Cognitive Assessment (MoCA) score in patients with PD in the older age group was significantly negatively correlated with gastrointestinal dysfunction (r=-0.252,P=0.012). After controlling for confounding factors, years of education were independently positively correlated with the total MoCA score (β=0.379,P<0.001), and UPDRS-Ⅲ scores were independently negatively correlated with the total MoCA score (β=-0.319,P=0.005), whereas none of the measures of autonomic function domains, including gastrointestinal, urinary, cardiovascular, thermoregulatory, and pupillomotor function, showed an independent significant association with the total MoCA score (all P>0.05). CONCLUSIONS: In older patients with PD, autonomic dysfunction is significantly correlated with motor function and cognitive function. Further univariate analysis suggests that gastrointestinal dysfunction is significantly associated with cognitive decline. In younger patients with PD, the association between autonomic dysfunction and cognitive function is not apparent.