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共病及其他临床和社会人口学因素对希腊帕金森病患者健康相关生活质量的影响。

The impact of comorbidity and other clinical and sociodemographic factors on health-related quality of life in Greek patients with Parkinson's disease.

机构信息

1st Department of Neurology, Medical School, Athens National and Kapodistrian University, 'Aeginition' Hospital, Greece.

出版信息

Aging Ment Health. 2011 Sep;15(7):913-21. doi: 10.1080/13607863.2011.569477. Epub 2011 May 24.

Abstract

OBJECTIVES

This study was designed to evaluate the impact of other common self-reported comorbid disorders (hypertension, dyslipidemia, ischemic heart disease, diabetes mellitus, minor stroke, arthritis, low back pain or osteoporosis and depression) on health-related Quality of Life (HRQoL) of Parkinson's disease (PD) patients and to explore the association of their HRQoL with various sociodemographic and clinical factors.

METHODS

Data about age, gender, education, occupation, income, marital and residential status, social relations, disease duration, functional status, treatment and concomitant diseases were collected of 139 Greek patients (68 men and 71 women) with PD. Patients were consecutively recruited from the outpatient clinic of the first Neurology Department of Athens National University at Aeginition Hospital. Disease severity was assessed using the unified Parkinson's disease rating scale including Hoehn and Yahr and Schwab and England (S&E) scales. HRQoL was measured by the specific Parkinson's disease questionnaire (PDQ-39). A multivariate multiple regression model with normal errors was used for the statistical analysis.

RESULTS

The main determinants of HRQoL were low degree of independence measured by the S&E scale (F = 35.942, p < 0.001), social isolation (F = 20.508, p < 0.001), disease duration (F = 14.983, p < 0.001), sleep (F = 6.507, p = 0.013) and gastrointestinal disturbances (F = 4.643, p = 0.035) and the presence of depression (F = 6.022, p = 0.017).

CONCLUSION

Among the other chronic comorbidities only depression was associated with a poor HRQoL in PD patients. Functional dependence and social isolation contributed most to worse HRQoL. Our findings suggest that adequate social support and management of depression, sleep and gastrointestinal disturbances could reduce the distress and improve HRQoL in patients with PD.

摘要

目的

本研究旨在评估其他常见的自报告合并症(高血压、血脂异常、缺血性心脏病、糖尿病、小中风、关节炎、下腰痛或骨质疏松症和抑郁症)对帕金森病(PD)患者健康相关生活质量(HRQoL)的影响,并探讨其 HRQoL 与各种社会人口学和临床因素的关系。

方法

收集了 139 名希腊 PD 患者(68 名男性和 71 名女性)的年龄、性别、教育、职业、收入、婚姻和居住状况、社会关系、疾病持续时间、功能状态、治疗和合并症等数据。患者连续从雅典国立大学第一神经内科雅典 Aeginition 医院的门诊招募。疾病严重程度使用统一帕金森病评定量表(包括 Hoehn 和 Yahr 量表和 Schwab 和 England 量表)进行评估。HRQoL 通过特定的帕金森病问卷(PDQ-39)进行测量。采用具有正态误差的多元多回归模型进行统计分析。

结果

HRQoL 的主要决定因素是 S&E 量表衡量的低独立性程度(F=35.942,p<0.001)、社会孤立(F=20.508,p<0.001)、疾病持续时间(F=14.983,p<0.001)、睡眠(F=6.507,p=0.013)和胃肠道紊乱(F=4.643,p=0.035)以及抑郁的存在(F=6.022,p=0.017)。

结论

在其他慢性合并症中,只有抑郁与 PD 患者的 HRQoL 较差相关。功能依赖和社会孤立对 HRQoL 的影响最大。我们的研究结果表明,提供足够的社会支持以及管理抑郁、睡眠和胃肠道紊乱可以减轻 PD 患者的痛苦并改善其 HRQoL。

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