Department of Neurology, Atrium Medical Center, Heerlen, The Netherlands; Department of Neurology, Nijmegen Center for Evidence Based Practice, Radboud University Nijmegen, Nijmegen, The Netherlands.
Department of Neurology, Atrium Medical Center, Heerlen, The Netherlands.
J Am Med Dir Assoc. 2014 Feb;15(2):90-4. doi: 10.1016/j.jamda.2013.10.007. Epub 2013 Dec 4.
Parkinson disease (PD) is common in long term care (LTC) facilities. The number of institutionalized patients with PD will rise sharply in the coming decades because of 2 concurrent phenomena: aging of the population leads to an increased PD prevalence and improved quality of care has led to a prolonged survival in advanced disease stages. Only a few studies have investigated the prevalence and clinical characteristics of patients with PD in LTC facilities. Even fewer studies have addressed the treatment strategies used to support these institutionalized patients, who are mostly in advanced stages of the disease. The available evidence suggests that current management of patients with PD in LTC facilities is less than optimal. In the Netherlands, and we suspect in many other countries, there are no formal guidelines for treating patients with PD who have been admitted to a LTC facility. In this review, we describe the epidemiology, clinical characteristics, and clinical management of patients with PD in LTC settings. We also address potentially modifiable elements of care and provide several recommendations to improve the management of PD in these facilities. We conclude by suggesting a possible guide for future research in this area.
帕金森病（PD）在长期护理（LTC）机构中很常见。由于两种同时存在的现象，机构中患有 PD 的患者数量将在未来几十年内急剧增加：人口老龄化导致 PD 的患病率增加，以及护理质量的提高导致晚期疾病阶段的生存时间延长。只有少数研究调查了 LTC 设施中 PD 患者的患病率和临床特征。更少的研究涉及用于支持这些已住院患者的治疗策略，这些患者大多处于疾病的晚期。现有证据表明，目前对 LTC 设施中 PD 患者的管理并不理想。在荷兰，我们怀疑在许多其他国家，对于已经入住 LTC 设施的 PD 患者，没有正式的治疗指南。在这篇综述中，我们描述了 LTC 环境中 PD 患者的流行病学、临床特征和临床管理。我们还讨论了护理中可能可改变的因素，并提出了一些建议，以改善这些设施中 PD 的管理。最后，我们提出了一个可能的指导，以促进该领域的未来研究。
