de Lau Lonneke M L, Verbaan Dagmar, Marinus Johan, van Hilten Jacobus J
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Slotervaart Hospital, P.O. Box 90440, 1006 BK Amsterdam, The Netherlands.
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Parkinsonism Relat Disord. 2014 Jun;20(6):613-6. doi: 10.1016/j.parkreldis.2014.02.030. Epub 2014 Mar 12.
Survival in patients with Parkinson's disease is reduced as compared to the general population. We aimed to identify motor and non-motor features that predict mortality in Parkinson's disease.
A broad range of motor and non-motor features were assessed in a hospital-based cohort of 414 patients with Parkinson's disease, who underwent five annual follow-up examinations including vital status assessment. Multivariable Cox's proportional hazards regression analysis was used to evaluate the association between baseline characteristics and mortality risk. Stepwise regression with backward elimination was carried out to determine the best model to predict mortality in Parkinson's disease.
After a mean follow-up period of 4.3 years, 49 (11.8%) patients had died. In the stepwise regression model, predictors of mortality in Parkinson's disease were higher age, male sex, cognitive impairment, higher postural instability gait disorder score, and the presence of psychotic symptoms.
Higher age, male sex, cognitive impairment, higher postural instability gait disorder score, and the presence of psychotic symptoms are independent predictors of decreased survival in Parkinson's disease. Mortality in Parkinson's disease thus seems to be affected mainly by non-dopaminergic and non-motor features.
与普通人群相比,帕金森病患者的生存率降低。我们旨在确定预测帕金森病患者死亡率的运动和非运动特征。
在一个以医院为基础的队列中,对414例帕金森病患者的一系列广泛的运动和非运动特征进行了评估,这些患者接受了包括生命状态评估在内的五次年度随访检查。采用多变量Cox比例风险回归分析来评估基线特征与死亡风险之间的关联。进行逐步回归并向后排除,以确定预测帕金森病死亡率的最佳模型。
在平均4.3年的随访期后,49例(11.8%)患者死亡。在逐步回归模型中,帕金森病死亡率的预测因素为年龄较大、男性、认知障碍、姿势不稳步态障碍评分较高以及存在精神症状。
年龄较大、男性、认知障碍、姿势不稳步态障碍评分较高以及存在精神症状是帕金森病患者生存率降低的独立预测因素。因此,帕金森病的死亡率似乎主要受非多巴胺能和非运动特征的影响。