Predictors of nursing home placement in Parkinson's disease: A population-based, prospective study
Predictors of nursing home placement in Parkinson's disease: A population-based, prospective study
复制标题
DOI：
10.1111/j.1532-5415.2000.tb06891.x
复制
发表时间：
2000-08-01
影响因子：
6.3
通讯作者：
Laake, K
中科院分区：
文献类型：
--
作者：
Aarsland, D;Larsen, JP;Laake, K
目的：探讨帕金森病患者疗养院安置的比率和预测因素。设计：四年前瞻性研究。背景：在挪威西部进行的一项基于人群的研究。参与者：178名帕金森氏病患者。测量：主要结果测量为从基线到养老院入住的时间。对运动症状（统一帕金森病评定量表，UPDRS）、认知（临床痴呆访谈，Gottfries， Brane & Steen痴呆量表和迷你精神状态检查）、抑郁（临床访谈和Montgomery & Asberg抑郁评定量表）和精神病症状（UPDRS思维障碍项目）进行基线评估。结果：在4年的研究期间，47名患者（26.4%）被送入养老院。与那些继续住在家里的患者相比，住在机构的患者年龄更大，患有更严重的帕金森病，有更严重的运动症状和日常生活活动障碍，认知受损更严重，更经常独自生活，出现更多幻觉。两组患者的病程、左旋多巴剂量和性别分布无差异。Cox比例风险线性回归分析显示，年龄、功能障碍、痴呆和幻觉是入住养老院的独立预测因素。结论：运动和神经精神症状都有助于机构化，但幻觉的存在是最强的预测因子。这一发现表明，对幻觉的有效治疗可能会减少帕金森病患者对机构的需求。
OBJECTIVES: To examine the rate and predictors of nursing home placement in patients with Parkinson's disease.DESIGN: Four-year prospective study.SETTING: A population-based study in western NorwayPARTICIPANTS: 178 community-dwelling subjects with Parkinson's disease. MEASUREMENTS: Main outcome measure was the time from baseline to nursing home admission. Baseline evaluation of motor symptoms (Unified Parkinson's Disease Rating Scale, UPDRS), cognition (clinical dementia interview, Gottfries, Brane & Steen dementia scale, and Mini-Mental State Examination), depression (clinical interview and the Montgomery & Asberg Depression Rating Scale), and psychotic symptoms (UPDRS Thought Disorder item) were performed.RESULTS: Forty-seven patients (26.4%) were admitted to a nursing home during the 4-year study period. Institutionalized patients were older, had more advanced Parkinson's disease with more severe motor symptoms and impairment of activities of daily living, were cognitively more impaired, were more often living alone, and had more hallucinations than those who continued to live at home. Duration of disease, levodopa dose, and gender distribution did not differ between the two groups. A Cox proportional hazards linear regression analysis showed that old age, functional impairment, dementia, and hallucinations were independent predictors of nursing home admission.CONCLUSIONS: Both motor and neuropsychiatric symptoms contributed to institutionalization, but the presence of hallucinations was the strongest predictor. This finding indicates it is possible that effective treatment of hallucinations may reduce the need for institutionalization in patients with Parkinson's disease.