Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
Parkinson Center Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands.
J Parkinsons Dis. 2018;8(4):495-498. doi: 10.3233/JPD-181374.
Recent epidemiological observations have drawn attention to the rapid rise in the burden caused by Parkinson's disease over the past years, emphasizing that Parkinson's disease is a matter of serious concern for our future generations. A recent report by Public Health England corroborates this message, by providing new insight on trends in deaths associated with neurological diseases in England between 2001 to 2014. The report indicates that mortality associated with Parkinson's disease and related disorders increased substantially between 2001 and 2014. This trend is partially explained by increased longevity in the population. However, it is possible that changes in exposure to risk factors, recent improvements in multidisciplinary care (leading to prolonged survival), and improved diagnostic awareness or improved registration also influenced the observed trend. Furthermore, patients with Parkinson's disease and related disorders were found to die at an advanced age, and the majority die in a care home or hospital, despite a preponderant preference for many patients and their families to spend their last days at home. To combat these concerning observations, future efforts should be focused on providing resources for vulnerable elderly Parkinson patients, avoiding unplanned hospital admissions and out-of-home deaths as much as possible. Possible solutions include a community-based network of specifically trained allied health therapists, personal case managers for Parkinson patients, dedicated Parkinson nursing homes, and improved centralised support services from university clinics to regional community hospitals aimed at facilitating optimal wide-scale care delivery.
最近的流行病学观察引起了人们对过去几年帕金森病负担迅速增加的关注,强调帕金森病是我们子孙后代严重关切的问题。英国公共卫生最近的一份报告证实了这一信息,该报告提供了 2001 年至 2014 年期间英格兰与神经疾病相关的死亡趋势的新见解。报告表明,2001 年至 2014 年期间,与帕金森病和相关疾病相关的死亡率大幅上升。这种趋势部分是由于人口寿命延长所致。然而,也有可能是由于接触危险因素的变化、最近多学科护理的改善(导致生存时间延长)、诊断意识的提高或登记的改善也影响了观察到的趋势。此外,帕金森病和相关疾病患者发现死亡年龄较大,大多数人在养老院或医院死亡,尽管许多患者及其家属首选在家中度过最后几天。为了应对这些令人担忧的观察结果,未来的工作重点应放在为弱势老年帕金森病患者提供资源上,尽量避免计划外的住院和外出死亡。可能的解决方案包括专门培训的联合健康治疗师的社区网络、帕金森病患者的个人病例经理、专门的帕金森护理院以及改善从大学诊所到地区社区医院的集中支持服务,旨在促进最佳的广泛护理。