Kataoka Hiroshi, Sugie Kazuma
Department of Neurology, Nara Medical University, Kashihara, Japan.
Neurol Clin Pract. 2021 Jun;11(3):e261-e266. doi: 10.1212/CPJ.0000000000000924.
Ten years ago, we examined 30 patients with Hoehn-Yahr stage III Parkinson disease (PD) to determine predictors related to falling, including walking speed, step number, and step time by using the originally designed narrowed paths. We verified the increased number of steps as greater risk for an upgrade of Hoehn-Yahr stage in a 6-year period. We further prospectively studied the same patients whether the step number on a sudden narrow path persists as a predictor of the severity of PD.
The follow-up patients were divided into 2 groups-patients with and without an increase in Hoehn-Yahr stage. Variables with a significant relation to the development of Hoehn-Yahr stage on a single variable logistic regression analysis ( < 0.05) were entered into multiple logistic regression analysis, adjusting both age and disease duration.
The significant variables between patients with and without an increase in Hoehn-Yahr stage were 36-item Short-Form Health Survey (SF-36) scores at 2, 4, 6, and 8 years. Multiple logistic regression analyses after adjusting both age and disease duration showed the SF-36 score at 2, 4, 6, and 8 years. The domain in social functioning significantly differed between patients with and without deterioration of Hoehn-Yahr stage in 10 years.
This study demonstrated the capacity of low health-related quality of life (HR-QOL) to predict future developments of PD staging in 10 years. The lower HR-QOL, particularly in social functioning, may reflect the severity of both motor and nonmotor symptoms.
十年前,我们对30例Hoehn-Yahr III期帕金森病(PD)患者进行了检查,以确定与跌倒相关的预测因素,包括行走速度、步数和步幅时间,采用最初设计的狭窄路径。我们验证了在6年时间里步数增加是Hoehn-Yahr分期升级的更大风险因素。我们进一步前瞻性研究了同一批患者,突然变窄路径上的步数是否持续作为PD严重程度的预测指标。
将随访患者分为两组——Hoehn-Yahr分期增加的患者和未增加的患者。在单变量逻辑回归分析中与Hoehn-Yahr分期发展有显著关系的变量(<0.05)被纳入多变量逻辑回归分析,同时调整年龄和病程。
Hoehn-Yahr分期增加和未增加的患者之间的显著变量是2年、4年、6年和8年时的36项简明健康调查(SF-36)得分。在调整年龄和病程后的多变量逻辑回归分析显示了2年、4年、6年和8年时的SF-36得分。在10年中,Hoehn-Yahr分期恶化和未恶化的患者在社会功能领域存在显著差异。
本研究证明了低健康相关生活质量(HR-QOL)预测10年内PD分期未来发展的能力。较低的HR-QOL,尤其是在社会功能方面,可能反映了运动和非运动症状的严重程度。