Association of caregiver strain with the trajectory of quality of life in Parkinson's disease.
Association of caregiver strain with the trajectory of quality of life in Parkinson's disease.
复制标题
护理人员压力与帕金森病患者生活质量轨迹的关系。
DOI：
10.1016/j.parkreldis.2023.105292
复制
发表时间：
2023
影响因子：
4.1
通讯作者：
Mills,KellyA
中科院分区：
文献类型：
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作者：
Perepezko,KateM;Gallo,JosephJ;Pontone,GregoryM;Hinkle,JaredT;Mills,KellyA
我们的目的是确定与帕金森病（PD）生活质量（QoL）轨迹相关的护理者特征。我们将生长混合模型拟合到帕金森基金会帕金森预后项目（POP）的纵向数据中，以确定帕金森病患者生活质量轨迹的异质性。然后，我们使用多项逻辑回归来模拟预测班级成员的基线因素。基线生长模型与4个疾病持续时间点测量的生活质量评分相拟合。确定了一个随机的截距和斜率模型，以最佳地拟合数据。接下来，用协变量（Hoehn & Yahr、性别和抑郁）拟合生长混合模型（1、2、3、4和5类），发现一个3类模型提供了最佳的拟合。第1类（问题类（10.0%））代表基线时生活质量较差，随着时间的推移改善较小的个体。第2类（中度类（32.6%））代表基线时生活质量中等，随时间轻度恶化的个体。第3组（有利组（56.9%））代表基线时生活质量良好，随着时间的推移略有恶化的个体。多项回归显示，较低的照顾者压力、较好的活动能力和较好的语言流畅性在基线上预测了与中等阶层相比，较好的成员资格。与温和阶层相比，流动性更差、年龄更年轻预示着问题阶层的成员资格。虽然之前的研究已经报道了活动能力和认知之间的关联，但护理人员压力与PD生活质量轨迹之间的关联的新发现表明，在未来的研究和实践中，护理人员压力是重要的测量和解决方法。
We aimed to identify caregiver characteristics associated with the trajectory of quality of life (QoL) in Parkinson's disease (PD). We fit a growth mixture model to longitudinal data from the Parkinson Foundation Parkinson's Outcomes Project (POP) to identify the heterogeneity of QOL trajectories in PD. We then used multinomial logistic regression to model baseline factors that predicted class membership. Baseline growth models were fit to QOL scores measured over 4 disease duration time points. A random intercept and slope model was determined to best fit the data. Next, growth mixture models (1, 2, 3, 4, and 5-class) were fit with covariates (Hoehn & Yahr, sex, and depression) and a three-class model was found to provide the best fit. Class 1 (problematic class (10.0%)) represented individuals with poor QOL at baseline and minor improvement over time. Class 2 (moderate class (32.6%)) represented individuals with moderate QOL at baseline with slight worsening over time. Class 3 (favorable class (56.9%)) represented individuals with good QOL at baseline and slight worsening over time. Multinomial regression revealed that lower caregiver strain, better mobility, and better verbal fluency at baseline predicted membership in the favorable compared to the moderate class. Worse mobility and younger age predicted membership in the problematic compared to the moderate class. While previous studies have reported on the association between mobility and cognition, the novel finding of an association between caregiver strain and PD QOL trajectory suggests caregiver strain is important to measure and address in future research and practice.