Barter Jolie D, Thomas Dwaina, Ni Liang, Bay Allison A, Johnson Theodore M, Prusin Todd, Hackney Madeleine E
Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA.
School of Arts and Sciences, Clark Atlanta University, Atlanta, GA 30314, USA.
Healthcare (Basel). 2023 May 4;11(9):1316. doi: 10.3390/healthcare11091316.
BACKGROUND/OBJECTIVE: Understanding the effects of multimorbidity on motor and cognitive function is important for tailoring therapies. Individuals with diabetes mellitus (DM) have a greater risk of developing Parkinson's disease (PD). This study investigated if individuals with comorbid PD and DM experienced poorer functional ability compared to individuals with only PD or DM.
A cross-sectional analysis of 424 individuals: healthy older adults (HOA), n = 170; PD without DM (PD-only), n = 162; DM without PD (DM-only), n = 56; and comorbid PD and DM (PD+DM), n = 36. Motor, motor-cognitive, cognitive, and psychosocial functions and PD motor symptoms were compared among groups using a two-way analyses of covariance with PD and DM as factors.
The PD-only and DM-only participants exhibited slower gait, worse balance, reduced strength, and less endurance. Motor-cognitive function was impaired in individuals with PD but not DM. DM-only participants exhibited impaired inhibition. Individuals with comorbid PD+DM had worse PD motor symptoms and exhibited impaired attention compared to the PD-only group.
Having PD or DM was independently associated with poorer physical and mental quality of life, depression, and greater risk for loss of function. Both PD and DM have independent adverse effects on motor function. Comorbid PD+DM further impairs attention compared to the effect of PD-only, suggesting the importance of therapies focusing on attention. Understanding the functional ability levels for motor and cognitive domains will enhance the clinical care for PD, DM, and PD+DM.
背景/目的：了解共病对运动和认知功能的影响对于制定个性化治疗方案至关重要。糖尿病（DM）患者患帕金森病（PD）的风险更高。本研究调查了PD合并DM的个体与仅患有PD或DM的个体相比，其功能能力是否更差。
对424名个体进行横断面分析：健康老年人（HOA），n = 170；无DM的PD（仅PD），n = 162；无PD的DM（仅DM），n = 56；以及PD合并DM（PD+DM），n = 36。以PD和DM作为因素，采用双向协方差分析比较各组之间的运动、运动认知、认知和心理社会功能以及PD运动症状。
仅PD组和仅DM组参与者的步态较慢、平衡较差、力量减弱且耐力较低。PD患者的运动认知功能受损，而DM患者未受损。仅DM组参与者的抑制功能受损。与仅PD组相比，PD合并DM的个体有更严重的PD运动症状且注意力受损。
患有PD或DM与较差的身心健康生活质量、抑郁以及功能丧失的更高风险独立相关。PD和DM对运动功能均有独立的不良影响。与仅PD的影响相比，PD合并DM进一步损害注意力，这表明关注注意力的治疗的重要性。了解运动和认知领域的功能能力水平将加强对PD、DM和PD+DM的临床护理。
