Sex differences in Parkinson's disease presentation and progression
Sex differences in Parkinson's disease presentation and progression
复制标题
DOI：
10.1016/j.parkreldis.2019.10.019
复制
发表时间：
2019-12-01
影响因子：
4.1
通讯作者：
Shulman, Lisa M.
中科院分区：
文献类型：
--
作者：
Abraham, Danielle S.;Gruber-Baldini, Ann L.;Shulman, Lisa M.
女性患帕金森病（PD）的风险较低。然而，目前尚不清楚性别是否是一个预后因素。我们的目的是研究差异的介绍，医生和患者报告的PD的结果，和进展的性别在一个大型的clinical coherent.Methods：这项研究是一个二级分析的PD患者在三级保健中心看到的队列。社会人口学和临床特征，治疗，护理时间和结果进行了检查的性别。用5年分段线性混合效应模型检验了损伤进展、残疾和健康相关生活质量（HRQoL）的性别差异。中介分析评估驱动程序的性别差异。结果：该研究包括914名男性和549名女性。与男性相比，女性在初次PD护理访视时的社会支持明显减少，心理困扰更多，自我报告（但不是医生报告）的残疾和HRQoL更差。解决焦虑症状可能会减弱这种差异。PD进展性别差异极小。结论：PD进展并不因性别而异，但患者报告的疾病严重程度的措施，女性比男性更差。为了减轻这种疾病经验的性别差异，心理困扰筛查和管理，特别是针对女性，应实施PD临床护理的一部分。
Introduction Females have a reduced risk of Parkinson's disease (PD). However, it is unclear if sex is a prognostic factor. We aimed to examine differences in presentation, physician- and patient-reported PD outcomes, and progression by sex in a large clinical cohort.Methods: This study was a secondary analysis of a cohort of PD patients seen at a tertiary care center. Sociodemographic and clinical characteristics, treatment, care timing, and outcomes were examined by sex. Sex differences in progression of impairment, disability, and health-related quality of life (HRQoL) were tested with five-year piecewise linear mixed-effects models. A mediation analysis assessed drivers of sex differences.Results: The study included 914 males and 549 females. Females had significantly less social support, more psychological distress, and worse self-reported (but not physician-reported) disability and HRQoL at initial PD care visits, compared to males. Addressing anxiety symptoms may attenuate this difference. PD progression sex differences were minimal.Conclusion: PD progression does not differ by sex, yet patient-reported measures of disease severity are worse in females than males. To attenuate this sex difference in disease experience, psychological distress screening and management, particularly targeting females, should be implemented as part of PD clinical care.