背景：近年來，有一些小型的個案研究顯示復健治療可能可以改善巴金森氏症患者的認知功能，但是缺乏大型的研究去證實其效果。
目標：了解新發的巴金森氏症患者中在發病後有無接受復健治療與之後發生失智症的關係。
方法：本研究為一回溯性世代研究。使用台灣健保資料庫2005年百萬抽樣歸人檔。從1997年至2002年底止5年間新發生的位巴金森氏症者患者，追蹤至2007年底為止，觀察所有追蹤期間內是否有使用復健運動治療及其發生失智症的機率是否相關。以Cox proportional hazard models分析整個追蹤期間在醫院接受復健治療的總次數與發生失智症的機率。控制其他相關因子，包括：性別、發病年齡、門診次數、住院日期、藥物強度及共病狀況等。
結果：在1998位新發巴金森氏症者患者中有744位曾經接受過復健治療，佔37.24%。而最後共有740位病患併發發失智症，佔37.04%。Kaplan-Meier存活分析顯示曾經接受過復健治療的組別有較低的機率併發失智症的發生密度(57.54 vs 49.36 (人/1000人年)，log-rank p=0.0226)。Cox proportional hazard models結果也顯示在控制其他相關因素後，病患在追蹤期間所接受的復健次數越多，得到失智症的機率越低(HR=0.999，p<0.0001)。
結論：巴金森氏症患者在接受復健治療後有較低的機率得到失智症且治療次數越多發病機率越低。

Parkinson’s disease is a common neurodegenerative disorder in the elderly. Dementia is common among Parkinson’s disease patients and it decreases patients’ functions and survival rate. The objective of this study was to investigate the influence of rehabilitation on preventing dementia in Parkinson’s disease patients. This retrospective cohort study analyzed data from the National Health Insurance Research Database in Taiwan. Patients with newly onset Parkinson’s disease from 1997 to 2002 were enrolled and followed up to 2007. Cox proportional hazard models were employed to evaluate the relationship between cumulative courses of rehabilitation training during the follow-up period and the incidence of new development of dementia in these Parkinson’s disease patients, adjusting for age, gender, drug use and comorbidity. A total of 1,998 patients was enrolled. Among them, 744 patients (37.2%) received a rehabilitation regimen in the follow-up period. The other 62.8% of patients (n=1,254) belonged to the control group. Over up to a 10-year follow-up, 264 patients (35.4%) with rehabilitation and 476 controls (38.0%) developed dementia, representing incidence densities of 57.5 and 49.4 per 1000 person-years, respectively. Cox models with adjustment of potential covariates showed each course of rehabilitation training lower the risk of dementia by 0.1%, and the effect appears to be greater for middle-aged adults than for older adults, and for men than for women. Rehabilitation may be able to prevent the subsequent dementia in patients with Parkinson’s disease patients. The effect of rehabilitation on dementia prevention is dose-dependent.

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