Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyvaskyla, Finland.
Department of Health Sciences, Lund University, Sweden.
J Gerontol A Biol Sci Med Sci. 2019 Mar 14;74(4):507-512. doi: 10.1093/gerona/gly074.
To describe life-space mobility and explore associations of motor and non-motor symptoms with life-space mobility in people with Parkinson's disease (PD).
About 164 community-dwelling persons with PD (mean age 71.6 years, 64.6% men) received a postal survey and a subsequent home visit. Motor assessments included perceived walking difficulties (Walk-12G), mobility (Timed Up and Go test), motor symptoms (UPDRS-III), and freezing of gait (item 3, FOG-Qsa). Non-motor symptoms included depressive symptoms (GDS-15), pain, fatigue (NHP-EN), and global cognition (MoCA). Life-space mobility was assessed with the life-space assessment (LSA). Calculations included composite score (range 0-120; higher indicating better life-space mobility), independent life-space (range 0-5), assisted life-space (range 0-5), and maximal life-space (range 0-5). Associations were analyzed with linear regression models, adjusted for age, sex, and PD severity (Hoehn and Yahr).
Mean life-space mobility score was 72.3 (SD = 28.8). Almost all participants (90%) reached the highest life-space level (beyond town). Half of these reached this level independently, while one-third were unable to move outside their bedroom without assistive devices or personal help. When adjusted for confounders, depressive symptoms, pain, and perceived walking difficulties was negatively associated with life-space mobility. In the multivariable model, only perceived walking difficulties were associated with life-space mobility.
Our findings indicate that perceived walking difficulties should be targeted to maintain or improve life-space mobility in people with PD. Depressive symptoms and pain may also merit consideration. More research is needed to elucidate the role of environmental and personal factors for life-space mobility in PD.
描述生活空间移动，并探讨帕金森病（PD）患者的运动和非运动症状与生活空间移动的关系。
约 164 名居住在社区的 PD 患者（平均年龄 71.6 岁，64.6%为男性）接受了邮寄调查和随后的家访。运动评估包括感知步行困难（Walk-12G）、移动能力（计时起立行走测试）、运动症状（UPDRS-III）和冻结步态（FOG-Qsa 项目 3）。非运动症状包括抑郁症状（GDS-15）、疼痛、疲劳（NHP-EN）和整体认知（MoCA）。生活空间移动能力通过生活空间评估（LSA）进行评估。计算包括综合评分（范围 0-120；分数越高表示生活空间移动能力越好）、独立生活空间（范围 0-5）、辅助生活空间（范围 0-5）和最大生活空间（范围 0-5）。使用线性回归模型进行关联分析，调整年龄、性别和 PD 严重程度（Hoehn 和 Yahr）。
平均生活空间移动评分得分为 72.3（SD=28.8）。几乎所有参与者（90%）都达到了最高的生活空间水平（超出城镇）。其中一半人独立达到了这一水平，而三分之一的人没有辅助设备或个人帮助就无法离开卧室。在调整混杂因素后，抑郁症状、疼痛和感知步行困难与生活空间移动能力呈负相关。在多变量模型中，只有感知步行困难与生活空间移动能力相关。
我们的研究结果表明，感知步行困难应作为目标，以维持或改善 PD 患者的生活空间移动能力。抑郁症状和疼痛也可能值得考虑。需要进一步研究阐明环境和个人因素对 PD 患者生活空间移动能力的作用。
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