Sakushima Ken, Yamazaki Shin, Fukuma Shingo, Hayashino Yasuaki, Yabe Ichiro, Fukuhara Shunichi, Sasaki Hidenao
Department of Neurology, Hokkaido University Graduate School of Medicine, Japan.
Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Japan.
J Neurol Sci. 2016 Jan 15;360:153-7. doi: 10.1016/j.jns.2015.11.055. Epub 2015 Nov 30.
Falling is one of the most common and serious public health problems. It can cause injuries such as sprains and fractures, and hospitalization may be required for serious injuries. Patients with Parkinson's disease have a higher risk of falls, and urinary incontinence is a known risk factor for falls in the elderly. However, whether other urinary disturbances contribute to the risk of falling remains unclear. The purpose of this study was to identify the association between falls and urinary disturbances in Parkinson's disease.
A prospective cohort study was conducted at a single institution with a 6-month observation period. Subjects were ambulatory patients with Parkinson's disease. Assessments included patient demographics, disease severity measured by the Hoehn and Yahr scale, and urinary disturbances measured using the overactive bladder symptom score (OABSS). Falls were reported using a self-documented fall record.
A total of 97 patients were included. Forty-four subjects experienced one or more falls during the observation period. The frequency of urination was not related to falling; however, mild urinary urgency, but not severe urinary urgency, increased the risk of falls by an odds ratio of 5.14 (95% confidence interval: 1.51-17.48). Mild urinary urgency was also associated with the time to the first fall and the frequency of falls. One third of falls occurred in the living room, and 13.8% of falls occurred on the way to/from the toilet.
Falls in patients with Parkinson's disease might be associated with urinary urgency, but not with the frequency of urination.
跌倒 是最常见且严重的公共卫生问题之一。它可导致诸如扭伤和骨折等损伤,严重损伤可能需要住院治疗。帕金森病患者跌倒风险更高,而尿失禁是老年人跌倒的已知风险因素。然而,其他排尿障碍是否会增加跌倒风险仍不明确。本研究的目的是确定帕金森病患者跌倒与排尿障碍之间的关联。
在单一机构进行了一项前瞻性队列研究,观察期为6个月。研究对象为帕金森病门诊患者。评估内容包括患者人口统计学信息、用霍恩和雅尔分级量表衡量的疾病严重程度,以及用膀胱过度活动症症状评分(OABSS)衡量的排尿障碍。跌倒情况通过自我记录的跌倒记录上报。
共纳入97例患者。44名受试者在观察期内经历了一次或多次跌倒。排尿频率与跌倒无关;然而,轻度尿急而非重度尿急使跌倒风险增加,优势比为5.14(95%置信区间:1.51 - 17.48)。轻度尿急还与首次跌倒时间及跌倒频率相关。三分之一的跌倒发生在客厅,13.8%的跌倒发生在往返厕所途中。
帕金森病患者的跌倒可能与尿急有关,但与排尿频率无关。