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瑞典斯德哥尔摩一项基于人群的多发性硬化症患者 10 年随访研究:残疾变化以及不同因素在预测残疾和死亡率方面的价值。

A 10-year follow-up of a population-based study of people with multiple sclerosis in Stockholm, Sweden: changes in disability and the value of different factors in predicting disability and mortality.

机构信息

Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.

出版信息

J Neurol Sci. 2013 Sep 15;332(1-2):121-7. doi: 10.1016/j.jns.2013.07.003. Epub 2013 Jul 26.

Abstract

BACKGROUND

Most people with multiple sclerosis (PwMS) experience progressively worsening disability over a period of decades, thus further knowledge about the long-term changes in different areas of disability is essential.

OBJECTIVES

The aims of this study were to evaluate changes in disability over ten years in PwMS, and to explore the value of personal and disease-specific factors and depressive symptoms in predicting disability. A further aim was to explore the value of these factors as predictors of mortality.

METHODS

This study was based on a 10-year follow-up of a population-based study in Stockholm (n=166). Home visits were used to collect data on personal and disease-specific factors, walking ability, manual dexterity, cognitive function, mood, activities of daily living (ADL) and social/lifestyle activities.

RESULTS

The proportion of the study population who had disability in cognition, mood and social/lifestyle activities remained stable, while the proportion with disability in walking, manual dexterity and ADL increased. Disease severity predicted an increase in all studied variables of disability except in depressive symptoms. Older age and depressive symptoms were associated with mortality.

CONCLUSION

This study illustrates the importance of tailored interventions for PwMS and highlights the need for health-care professionals to consider the psychological aspects of the disease. Furthermore, our results indicate that the Expanded Disability Status Scale was a useful tool for predicting future disability.

摘要

背景

大多数多发性硬化症患者(PwMS)在几十年的时间里经历着逐渐恶化的残疾,因此进一步了解残疾的不同领域的长期变化是至关重要的。

目的

本研究旨在评估 PwMS 十年间残疾的变化,并探讨个人和疾病特异性因素以及抑郁症状在预测残疾中的价值。另一个目的是探讨这些因素作为死亡率预测因子的价值。

方法

本研究基于斯德哥尔摩(n=166)一项基于人群的 10 年随访研究。通过家访收集个人和疾病特异性因素、行走能力、手灵巧度、认知功能、情绪、日常生活活动(ADL)和社会/生活方式活动的数据。

结果

研究人群中认知、情绪和社会/生活方式活动残疾的比例保持稳定,而行走、手灵巧度和 ADL 残疾的比例增加。疾病严重程度预测了所有研究残疾变量的增加,除了抑郁症状。年龄较大和抑郁症状与死亡率相关。

结论

本研究说明了为 PwMS 量身定制干预措施的重要性,并强调了医疗保健专业人员需要考虑疾病的心理方面。此外,我们的结果表明,扩展残疾状况量表是预测未来残疾的有用工具。

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