Akhmedullin Ruslan, Gusmanov Arnur, Zhakhina Gulnur, Crape Byron, Aimyshev Temirgali, Semenova Yuliya, Kyrgyzbay Gaziz, Gaipov Abduzhappar
Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan.
Department of Functional Diagnostics, RSE Medical Centre Hospital of the President's Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan.
Parkinsons Dis. 2025 May 1;2025:4317554. doi: 10.1155/padi/4317554. eCollection 2025.
This study explores the burden of Parkinson's disease (PD) in Kazakhstan, the largest country in Central Asia, a region where data on neurological disorders are notably sparse. Utilizing data from Kazakhstan's Unified National Electronic Health System during 2014-2021, the study investigates the epidemiology, disability-adjusted life years (DALYs), and survival outcomes in a cohort of PD patients. The authors employed Cox proportional hazards regression models and Kaplan-Meier analysis, alongside sensitivity analyses, to assess the impact of demographic factors, hypertension, and the Charlson Comorbidity Index (CCI) on survival. The study cohort included 10,125 patients, revealing a tenfold increase in PD prevalence during the study period. Mortality rates varied significantly, with the highest rates observed in the eldest age group (137.05 per 1000 person-years). PD contributed to a loss of 156.12 DALYs per 100,000 population, primarily driven by years of life lost. The analysis identified an increased risk of all-cause mortality among males (adjusted hazard ratio (aHR) 1.6; 1.5-1.8), older individuals (aHR 1.05; 1.04-1.06), those with higher CCIs, and individuals of Kazakh ethnicity. Interestingly, patients with comorbid hypertension had a higher probability of survival (aHR 0.67; 0.60-0.73). This study is the first of its kind in Central Asia to examine the burden of PD using a large-scale outpatient registry. The findings underscore the need for targeted interventions to address the growing burden of PD, particularly among males and ethnic Kazakhs. Additionally, further research is needed to explore the inverse association between hypertension and survival in the PD cohort.
本研究探讨了帕金森病（PD）在中亚最大的国家哈萨克斯坦的负担情况，该地区关于神经疾病的数据极为稀少。利用哈萨克斯坦统一国家电子卫生系统2014 - 2021年的数据，该研究调查了一组帕金森病患者的流行病学、伤残调整生命年（DALYs）和生存结局。作者采用Cox比例风险回归模型和Kaplan - Meier分析以及敏感性分析，以评估人口统计学因素、高血压和查尔森合并症指数（CCI）对生存的影响。研究队列包括10125名患者，显示研究期间帕金森病患病率增加了十倍。死亡率差异显著，最高死亡率出现在最年长年龄组（每1000人年137.05例）。帕金森病导致每10万人口损失156.12个伤残调整生命年，主要由生命年损失所致。分析发现男性（调整后风险比（aHR）1.6；1.5 - 1.8）、老年人（aHR 1.05；1.04 - 1.06）、CCI较高者以及哈萨克族个体全因死亡风险增加。有趣的是，合并高血压的患者生存概率更高（aHR 0.67；0.60 - 0.73）。本研究是中亚首个使用大规模门诊登记数据来研究帕金森病负担的此类研究。研究结果强调了需要采取有针对性的干预措施来应对帕金森病日益加重的负担，尤其是在男性和哈萨克族人群中。此外，还需要进一步研究以探索帕金森病队列中高血压与生存之间的反向关联。
