Second Department of Neurology, Faculty of Medicine, Comenius University in Bratislava, University Hospital Bratislava, Slovakia.
First Department of Psychiatry, Pavol Jozef Šafarik University, Košice, Slovakia.
Neuro Endocrinol Lett. 2022 Apr;43(1):39-44.
Co-morbidities in any disorder can complicate its diagnostic process, they require more complex clinical management and lead to worse health outcomes and increased healthcare costs. There are regional differences in the prevalence of specific co-morbidities in Parkinson's disease (PD), and data from middle Europe are lacking. The project COSMOS aimed to disclose the prevalence of co-morbidities among patients with PD in Slovakia.
In a national, multi-center, cross-sectional, observational study, neurologists gathered relevant demographical and clinical data aimed at all psychiatric and somatic co-morbidities.
From overall 737 patients, 51.00 % had at least one psychiatric co-morbidity, the most prevalent were depressive episode/recurrent depressive disorder (26.05%), sleep disorders (23.20%), dementia (13.16%), and neurotic, stress-related, and somatoform disorders (11.53%). In addition, 92.9 % had at least one somatic co-morbidity, the most prevalent were hypertensive diseases (67.71%), ischemic heart diseases (42.74%), diseases of the musculoskeletal system, and connective tissue (39.21), and disorders of lipoprotein metabolism (33.24%). The number of psychiatric co-morbidities increased with PD progression; the prevalence of somatic comorbidities increased also with the age (p<0.001 in all cases).
This study with a large cohort of PD patients confirmed a high prevalence of depression, dementia, sleep problems, and anxiety disorders, together with cardiovascular disorders, diseases of the musculoskeletal system, and metabolic syndrome. With PD progression, the number of both psychiatric and somatic co-morbidities is on the increase. If not treated properly, they lead to more complicated management. That's why it's essential to search for any co-morbidity to provide patients with early and adequate therapy to avoid further worsening of quality of life.
任何疾病的合并症都会使其诊断过程复杂化，需要更复杂的临床管理，并导致更差的健康结果和增加医疗保健成本。在帕金森病（PD）中，特定合并症的流行程度存在地区差异，而来自中欧的数据则不足。COSMOS 项目旨在揭示斯洛伐克 PD 患者合并症的流行情况。
在一项全国性、多中心、横断面、观察性研究中，神经病学家收集了旨在涵盖所有精神和躯体合并症的相关人口统计学和临床数据。
在总共 737 名患者中，有 51.00%至少有一种精神合并症，最常见的是抑郁发作/复发性抑郁障碍（26.05%）、睡眠障碍（23.20%）、痴呆症（13.16%）和神经症、应激相关和躯体形式障碍（11.53%）。此外，92.9%至少有一种躯体合并症，最常见的是高血压疾病（67.71%）、缺血性心脏病（42.74%）、肌肉骨骼系统和结缔组织疾病（39.21%）以及脂蛋白代谢紊乱（33.24%）。精神合并症的数量随着 PD 的进展而增加；躯体合并症的患病率也随着年龄的增加而增加（所有情况下均<0.001）。
这项对大量 PD 患者的研究证实了抑郁、痴呆、睡眠问题和焦虑障碍的高患病率，以及心血管疾病、肌肉骨骼系统疾病和代谢综合征。随着 PD 的进展，精神和躯体合并症的数量都在增加。如果不进行适当治疗，它们会导致更复杂的管理。因此，有必要寻找任何合并症，为患者提供早期和适当的治疗，以避免生活质量进一步恶化。
