帕金森病患者的衰弱及其与早期痴呆的关系：一项纵向研究。

Frailty in Parkinson's disease and its association with early dementia: A longitudinal study.

机构信息

Centre for Age-Related Medicine (SESAM), Stavanger University Hospital. Stavanger, Norway; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.

Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia; Geriatric Medicine Research, Dalhousie University, Nova Scotia Health Authority, Halifax, NS, Canada; Geriatric Epidemiology Research Department, Instituto Nacional De Geriatría (INGER), Mexico City, Mexico; Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Huixquilucan Edo. de México, Mexico.

出版信息

Parkinsonism Relat Disord. 2022 Jun;99:51-57. doi: 10.1016/j.parkreldis.2022.05.004. Epub 2022 May 13.

DOI:10.1016/j.parkreldis.2022.05.004

PMID:35598420

Abstract

INTRODUCTION

Frailty is recognized as a clinical condition associated with increased vulnerability for developing negative health outcomes but has been little studied in patients with Parkinson's disease (PD). Here, we investigated the risk of frailty in de novo PD patients and its association with subsequent development of dementia.

METHODS

We conducted a three-year longitudinal population-based study of 192 drug-naive newly diagnosed PD patients and 172 controls (No-PD) matched for age, sex, and education. Frailty was measured using the frailty index (FI). Logistic regression models, adjusting for potential confounders, were conducted to assess the association between frailty at the time of PD diagnosis and the subsequent odds for developing PD dementia during follow-up.

RESULTS

The mean baseline FI score was higher in the PD (0.21 ± 0.10) than in the No-PD group (0.11 ± 0.07, p < 0.001). One-third of PD patients had high-FI (>0,25), compared to 5% in the no-PD group. Participants with PD had an increased risk to present frailty with an odds ratio (OR) of 6.68 (SE 2.70 IC 95% [3.15; 15.62], p-value <0.001) compared to the No-PD group. PD Participants with greater FI measured at baseline had increased odds of having dementia within three years of follow-up, after adjustment for age and sex (OR 2.91 SE 1.00 IC 95% [1.54; 5.99] p-value = 0.002).

CONCLUSION

Frailty is common in people with newly diagnosed PD and associated with increased odds for subsequent development of dementia in a three-year follow-up. This study emphasizes the prognostic importance of frailty in PD from the earliest clinical stages.

摘要

简介

衰弱被认为是一种与负面健康结果风险增加相关的临床状况，但在帕金森病 (PD) 患者中研究甚少。在这里，我们调查了新发 PD 患者衰弱的风险及其与随后痴呆发展的关系。

方法

我们进行了一项为期三年的基于人群的纵向研究，纳入了 192 名初诊的、未经药物治疗的新发 PD 患者和 172 名年龄、性别和教育程度相匹配的对照者（非 PD 组）。使用衰弱指数（FI）测量衰弱。采用调整潜在混杂因素的 logistic 回归模型，评估 PD 诊断时的衰弱与随访期间发生 PD 痴呆的后续比值比（OR）之间的关系。

结果

PD 组的基线 FI 评分均值较高（0.21±0.10），而非 PD 组较低（0.11±0.07，p<0.001）。三分之一的 PD 患者存在高 FI（>0.25），而非 PD 组为 5%。与非 PD 组相比，PD 患者出现衰弱的风险增加，OR 为 6.68（SE 2.70 95%CI [3.15; 15.62]，p 值<0.001）。与基线 FI 较高的 PD 患者相比，在调整年龄和性别后，在三年随访期间发生痴呆的风险增加（OR 2.91 SE 1.00 95%CI [1.54; 5.99]，p 值=0.002）。