Falls in Parkinson Disease: Analysis of a Large Cross-Sectional Cohort
Falls in Parkinson Disease: Analysis of a Large Cross-Sectional Cohort
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DOI：
10.3233/jpd-130249
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发表时间：
2013-01-01
影响因子：
5.2
通讯作者：
Gurevich, Tanya
中科院分区：
文献类型：
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作者：
Parashos, Sotirios A.;Wielinski, Catherine L.;Gurevich, Tanya
背景：福尔斯仍然是帕金森病发病的重要原因。危险因素还没有很好地understood.Objective：在这项研究中，我们探讨的风险因素，福尔斯在PD利用横截面，基线数据在国家帕金森基金会质量改进计划（NPF-QII）数据库。受试者正在进行前瞻性随访，这项研究将提供后续的纵向analysis.Methods的基础上：一个横断面分析的数据从2,876例非卧床帕金森病患者在NPF-QII在18个网站。主要结果指标是评估前3个月的跌倒史。以下被认为是可能的预测变量：年龄、性别、身高、体重、体重指数、疾病持续时间、疾病发作时的年龄、研究者对诊断的信心、Hoehn和Yahr分期、静止性震颤、无辅助站立能力、共存病理（心血管、呼吸系统、糖尿病、癌症、神经系统、骨关节炎和“其他”合并症），抗胆碱能药，抗抑郁药，抗精神病药，认知增强剂，脑深部电刺激手术，定时启动，语义流畅性和5个单词的回忆。在多变量模型中使用logistic regression.Results：37.2%的受试者经历了福尔斯。在多变量回归模型中，发现以下变量与福尔斯独立相关：病程; Hoehn和Yahr分期;无静息震颤;心血管，关节炎，或“其他”合并症;抗抑郁药;脑深部电刺激手术;定时和去;和，语义fluency.Conclusion：病程，而不是年龄与帕金森病的福尔斯独立相关。定时上升和上升准确地反映了福尔斯风险。语义流畅性受损与福尔斯独立相关，而非文字记忆则不相关。合并症、抗抑郁药和脑深部电刺激也会增加福尔斯跌倒的风险。
Background: Falls remain a significant cause of morbidity in PD. Risk factors are not well understood.Objective: In this study we explore risk factors for falls in PD utilizing the cross-sectional, baseline data in the National Parkinson Foundation Quality Improvement Initiative (NPF-QII) database. Subjects are being followed prospectively, and this study will provide the basis for subsequent longitudinal analyses.Methods: A cross-sectional analysis of data from 2,876 ambulatory patients with Parkinson disease enrolled in the NPF-QII at 18 sites. Main outcome measure was falling history in the 3 months preceding assessment. The following were considered as possible predictor variables: age, sex, height, weight, body mass index, disease duration, age at disease onset, investigator's confidence in the diagnosis, Hoehn and Yahr stage, rest tremor, ability to stand unassisted, coexistent pathologies (cardiovascular, respiratory, diabetes, cancer, neurological, osteoarthritis, and "other" comorbidities), anticholinergics, antidepressants, antipsychotics, cognitive enhancers, deep brain stimulation surgery, timed-up-and-go, semantic fluency, and 5 word recall. Variables with associations to the outcome measure in univariate analyses were analyzed in multivariable models using logistic regression.Results: 37.2% of subjects experienced falls. In the multivariable regression model the following variables were found to be independently associated with falls: disease duration; Hoehn and Yahr stage; absence of rest tremor; cardiovascular, arthritis, or "other" comorbidity; antidepressants; deep brain stimulation surgery; timed-up-and-go; and, semantic fluency.Conclusion: Disease duration but not age is independently associated with falls in Parkinson disease. Timed-up-and-go accurately reflects falls risk. Impaired semantic fluency is independently associated with falls, while verbal memory is not. Comorbidities, antidepressants, and deep brain stimulation also contribute to falls risk.