Laboratoire de Pharmacologie Médicale et Clinique, UMR Inserm 1027, CHU de Toulouse, France.
Pôle Pharmacie, UMR Inserm 1027, CHU de Toulouse, France.
J Am Med Dir Assoc. 2017 Sep 1;18(9):791-796. doi: 10.1016/j.jamda.2017.04.014. Epub 2017 Jun 13.
To evaluate mortality rate in elderly and very elderly (≥85 years) residents with Parkinson disease (PD) in nursing homes (NHs) with and without antipsychotic drugs.
Cross-sectional study.
All residents with PD from the 6275 NH residents participating in the Impact d'une démarche QUAlité sur l'évolution des pratiques et le déclin fonctionnel des Résidents en Etablissement d'hébergement pour personnes âgées dépendantes (IQUARE) study.
A total of 175 NHs in Midi-Pyrénées region, South-Western France.
Patients with PD taking antipsychotic drugs.
All-cause mortality between baseline and 18 months.
Logistic regression was used to explore baseline characteristics associated with mortality rate and with antipsychotic use at 18 months.
At baseline, among 452 residents with PD, 72 (15.9%) received at least 1 antipsychotic drug. Mortality rates at 18 months in residents with PD with and without antipsychotic use were similar (34.3% and 38.2%, respectively, P = .58). Among factors associated with mortality, a statistically significant increase in mortality rate was found in very old residents (≥85 years of age) [odds ratio (OR) 2.0; 95% confidence interval (CI) 1.3-3.1] or in those with chronic pulmonary disease (OR 3.6; 95% CI 1.5-8.5). Among residents ≥85 years of age, we also found a statistically significant increase in mortality rate in individuals with arterial hypertension (OR 2.8; 95% CI 1.3-5.8). Moreover, a statistically significant increase in prescription of antipsychotic drugs was found in residents who tried to elope (OR 3.8; 95% CI 1.4-10.7) and in those with severe psychiatric diseases (excluding depression) (OR 7.5; 95% CI 4.1-13.6).
In this study investigating factors associated with mortality in old and very old residents with PD in NHs, no significant association was observed with the use of antipsychotics. However, our study suggests that age (≥85 years) or chronic pulmonary disease could be associated with mortality among patients with PD, as well as arterial hypertension in very old patients (≥85 years of age).
评估养老院（NH）中接受和未接受抗精神病药物治疗的老年（≥85 岁）和非常老年（≥85 岁）帕金森病（PD）患者的死亡率。
横断面研究。
参与 Impact d'une démarche QUAlité sur l'évolution des pratiques et le déclin fonctionnel des Résidents en Etablissement d'hébergement pour personnes âgées dépendantes（IQUARE）研究的 6275 名 NH 居民中所有患有 PD 的居民。
法国西南部米迪-庇里牛斯地区的 175 家 NH。
服用抗精神病药物的 PD 患者。
基线至 18 个月的全因死亡率。
使用逻辑回归探索与死亡率相关的基线特征以及与 18 个月时抗精神病药物使用相关的特征。
在 452 名患有 PD 的居民中，72 名（15.9%）至少服用了 1 种抗精神病药物。在使用和不使用抗精神病药物的 PD 患者中，18 个月时的死亡率相似（分别为 34.3%和 38.2%，P=.58）。在与死亡率相关的因素中，我们发现非常高龄（≥85 岁）的居民[比值比（OR）2.0；95%置信区间（CI）1.3-3.1]或患有慢性肺部疾病（OR 3.6；95%CI 1.5-8.5）的死亡率显著增加。在≥85 岁的居民中，我们还发现患有动脉高血压（OR 2.8；95%CI 1.3-5.8）的个体死亡率显著增加。此外，试图逃跑（OR 3.8；95%CI 1.4-10.7）和患有严重精神疾病（不包括抑郁症）（OR 7.5；95%CI 4.1-13.6）的居民抗精神病药物处方显著增加。
在这项研究中，我们调查了 NH 中患有 PD 的老年和非常老年居民的死亡率相关因素，未观察到抗精神病药物使用与死亡率之间存在显著关联。然而，我们的研究表明，年龄（≥85 岁）或慢性肺部疾病可能与 PD 患者的死亡率相关，以及非常高龄（≥85 岁）患者的动脉高血压也与死亡率相关。
