Song Shengfang, Luo Zhehui, Plassman Brenda L, Huang Xuemei, Yuan Yaqun, Shrestha Srishti, Parks Christine G, Hofmann Jonathan N, Beane Freeman Laura E, Sandler Dale P, Chen Honglei
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
Mov Disord. 2025 May;40(5):855-868. doi: 10.1002/mds.30149. Epub 2025 Feb 14.
BACKGROUND: Few studies have assessed motor and nonmotor symptoms and the prodromal probability of Parkinson's disease (PD) among farming populations. OBJECTIVE: The aim was to assess self-reported nonmotor and motor symptoms and the prodromal PD probability in relation to incident PD among US farmers. METHODS: The study included 16,059 farmers (aged 65.6 ± 10.8 years) from the Agricultural Health Study, with a median of 6.2 years of follow-up. We assessed associations using multivariable logistic regression and presented odds ratios (OR) and 95% confidence intervals (CI). RESULTS: At baseline, the prevalence of individual symptoms ranged from 2.0% for arm/leg tremor to 21.1% for excessive daytime sleepiness. We identified 127 incident PD patients during follow-up. Except for depression, all symptoms were significantly associated with future PD diagnosis, with OR (95% CI) ranging from 1.6 (1.1-2.2) for excessive daytime sleepiness to 3.9 (2.3-6.8) for arm/leg tremor. The prodromal PD probability, calculated based on limited available self-reported prodromal and PD risk markers, was low. Using the Movement Disorder Society's prodromal PD criteria, the median (interquartile range) at baseline was 4.4% (7.2%) for incident PD patients and 2.3% (3.4%) for participants free of PD. Further, it exhibited low sensitivity and positive predictive value in identifying incident PD patients in this farming population. CONCLUSIONS: Self-reported prodromal PD symptoms were relatively common in US farmers. They were associated with incident PD diagnosis but had limited values in predicting disease risk. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.
背景:很少有研究评估务农人群中帕金森病(PD)的运动和非运动症状以及前驱期患病概率。 目的:旨在评估美国农民自我报告的非运动和运动症状以及与新发PD相关的前驱期PD患病概率。 方法:该研究纳入了农业健康研究中的16,059名农民(年龄65.6±10.8岁),中位随访时间为6.2年。我们使用多变量逻辑回归评估关联,并给出优势比(OR)和95%置信区间(CI)。 结果:在基线时,个体症状的患病率从手臂/腿部震颤的2.0%到白天过度嗜睡的21.1%不等。随访期间我们确定了127例新发PD患者。除抑郁外,所有症状均与未来PD诊断显著相关,OR(95%CI)范围从白天过度嗜睡的1.6(1.1 - 2.2)到手臂/腿部震颤的3.9(2.3 - 6.8)。根据有限的可用自我报告的前驱期和PD风险标志物计算出的前驱期PD患病概率较低。使用运动障碍协会的前驱期PD标准,基线时新发PD患者的中位数(四分位间距)为4.4%(7.2%),无PD参与者为2.3%(3.4%)。此外,在识别该务农人群中的新发PD患者时,其敏感性和阳性预测值较低。 结论:自我报告的前驱期PD症状在美国农民中相对常见。它们与新发PD诊断相关,但在预测疾病风险方面价值有限。© 2025作者。由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版的《运动障碍》。本文由美国政府雇员贡献,其在美国属于公共领域。
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