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临床因素预测帕金森病患者自愿停止驾驶。

Clinical Factors Predicting Voluntary Driving Cessation among Patients with Parkinson's Disease.

机构信息

Department of Neurology, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan.

Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.

出版信息

Behav Neurol. 2022 Mar 20;2022:4047710. doi: 10.1155/2022/4047710. eCollection 2022.

Abstract

Factors that influence the decision of voluntary driving cessation in patients living with Parkinson's disease (PD) are still unclear. We aimed to reveal the factors affecting the decision of voluntary driving cessation in patients with PD. This hospital-based cross-sectional study recruited consecutive outpatients with PD. Data on sociodemographic and clinical characteristics and medication use were collected from the patients using semistructured interviews. Cognitive function was evaluated using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). We excluded patients with dementia or motor impairment (Hoehn - Yahr stage > 3). We divided the patients into two groups, with and without voluntary driving cessation (D: driver; RD: retired driver), and conducted investigations using multivariate logistic regression analyses. Of the 40 patients, 8 (20.0%) voluntarily retired from driving. Patients who decided on driving cessation had a higher prevalence of freezing of gait (FOG) (D vs. RD, 25.0% vs. 87.5%; = 0.001) and tended to have lower scores for attention in the MoCA-J (D vs. RD, 5.0 ± 1.2 vs. 4.1 ± 1.4; = 0.086). Multivariable analysis showed that FOG was independently associated with driving cessation (odds ratio: 14.46, 95% confidence interval: 1.91-303.74). FOG was associated with voluntary driving cessation in patients with PD without dementia or severe motor impairment. Physicians should consider providing extensive social support to maintain patients' mobility and independence, especially if the patients have these clinical factors.

摘要

影响帕金森病(PD)患者自愿停车决策的因素仍不清楚。我们旨在揭示影响 PD 患者自愿停车决策的因素。这项基于医院的横断面研究招募了连续的 PD 门诊患者。使用半结构化访谈从患者那里收集社会人口统计学和临床特征以及药物使用数据。使用日本版蒙特利尔认知评估(MoCA-J)评估认知功能。我们排除了痴呆或运动障碍患者(Hoehn-Yahr 分期> 3)。我们将患者分为有和无自愿停车(D:驾驶员;RD:退休驾驶员)两组,并使用多变量逻辑回归分析进行调查。在 40 名患者中,有 8 名(20.0%)自愿停止驾驶。决定停车的患者更常出现冻结步态(FOG)(D 与 RD,25.0%与 87.5%;= 0.001),并且 MoCA-J 中的注意力评分往往较低(D 与 RD,5.0 ± 1.2 与 4.1 ± 1.4;= 0.086)。多变量分析显示,FOG 与停车决策独立相关(优势比:14.46,95%置信区间:1.91-303.74)。FOG 与无痴呆或严重运动障碍的 PD 患者自愿停车有关。医生应考虑提供广泛的社会支持,以维持患者的活动能力和独立性,特别是如果患者有这些临床因素。

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