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共病与衰弱:帕金森病复杂性的应对策略。

Multimorbidity and Frailty: Tackling Complexity in Parkinson's Disease.

机构信息

Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.

Older People's Unit, Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, United Kingdom.

出版信息

J Parkinsons Dis. 2020;10(s1):S85-S91. doi: 10.3233/JPD-202105.

Abstract

Parkinson's disease (PD) is a condition that predominantly affects older people. It is imperative that clinical management considers the other significant illnesses that people with PD accumulate as they age in conjunction with their resilience to cope with physiological change. Multimorbidity and frailty act synergistically to heighten the risk of adverse outcomes for older people with PD. These states are associated with increased likelihood of hospitalization, polypharmacy, adverse drug effects including the anticholinergic burden of medications, drug-disease and drug-drug interactions. Management should be integrated, holistic and individualised to meticulously balance the risks of interventions considering the vulnerability of the individual to recover from disturbance to their environmental, physical and cognitive equilibrium.

摘要

帕金森病(PD)主要影响老年人。临床管理必须考虑到随着 PD 患者年龄的增长,他们会患上其他重大疾病,以及他们应对生理变化的能力。多病共存和脆弱性协同作用,增加了 PD 老年患者不良结局的风险。这些状态与住院、多种药物治疗、药物不良反应(包括药物的抗胆碱能负担)、药物-疾病和药物-药物相互作用的可能性增加有关。管理应该是综合的、整体的和个体化的,以仔细平衡干预的风险,考虑到个体从环境、身体和认知平衡的干扰中恢复的脆弱性。

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