Handberg Charlotte, Rudolfsen Jan Håkon, Andersen Henning, Vissing John, Rossau Charlotte Dahl, Dreyer Pia, Olsen Jens, Bengtsson Simone D, Aagaard Heidi, Werlauff Ulla
National Rehabilitation Centre for Neuromuscular Diseases, Aarhus, Denmark.
Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.
Eur J Neurol. 2025 Jun;32(6):e70211. doi: 10.1111/ene.70211.
Adult-onset myotonic dystrophy type 1 (DM1) is characterised by diagnostic delay due to milder symptomatology than the congenital and juvenile forms. The multiorgan symptoms in the multiorgan nature of DM1 have negative biopsychosocial consequences. The aim was to apply national health registers to provide updated knowledge on the use and costs of healthcare services and labour market affiliation of persons with adult-onset DM1 in Denmark.
Analyses were based on a population of 949 adult persons with DM1 and 9427 controls. Median age at diagnosis was 43 years. Each person with DM1 was matched with ten reference individuals from the general Danish population without DM1. Data were retrieved from several databases: Statistics Denmark, the Danish National Patient Register, Danish National Health Service Register, the Danish National Prescription Registry and the Income register and the DREAM database.
During the 20-year following diagnosis, persons with DM1 had 2.5 times more inpatient contacts, 2 times more outpatient contacts and 29.1 times more hours of home care than their controls. Persons with DM1 had a lower educational level, a higher risk of early disability pension (HR: 11.6, CI: 9.92-13.6), 68.2 weeks more unemployment and 29.2 weeks more long-term sick leave and EUR 11,700-23,500 a lower income per year of the study. For all results, the difference between persons with DM1 and their controls was more expressed in males.
The course of disease in adult-onset DM1-normally considered to be mild-has a significant impact on health and living conditions.
成人起病的1型强直性肌营养不良(DM1)的特点是,由于症状比先天性和青少年型更为轻微,导致诊断延迟。DM1多器官病变的性质所引发的多器官症状会产生负面的生物心理社会后果。目的是利用国家健康登记系统,提供关于丹麦成人起病的DM1患者医疗服务使用情况、费用以及劳动力市场归属的最新知识。
分析基于949名成年DM1患者和9427名对照人群。诊断时的中位年龄为43岁。每名DM1患者与十名来自丹麦普通人群且无DM1的参照个体进行匹配。数据从多个数据库中检索:丹麦统计局、丹麦国家患者登记系统、丹麦国家卫生服务登记系统、丹麦国家处方登记系统、收入登记系统以及DREAM数据库。
在诊断后的20年里,DM1患者的住院接触次数是对照组的2.5倍,门诊接触次数是对照组的2倍,家庭护理时长是对照组的29.1倍。DM1患者的教育水平较低,提前领取残疾抚恤金的风险较高(风险比:11.6,置信区间:9.92 - 13.6),失业时间多出68.2周,长期病假时间多出29.2周,且在研究期间每年收入低11,700 - 23,500欧元。对于所有结果,DM1患者与其对照组之间的差异在男性中表现得更为明显。
通常被认为症状较轻的成人起病DM1的病程,对健康和生活状况有重大影响。