The effects of medical comorbidity, cognition, and age on patient-reported outcomes in Parkinson's disease.
The effects of medical comorbidity, cognition, and age on patient-reported outcomes in Parkinson's disease.
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医疗共病、认知和年龄对帕金森病患者报告结果的影响。
DOI：
10.1016/j.parkreldis.2023.105892
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发表时间：
2023-10
影响因子：
4.1
通讯作者：
Haesung Kim;L. M. Shulman;Sunita Shakya;Ann Gruber-Baldini
中科院分区：
文献类型：
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作者：
Haesung Kim;L. M. Shulman;Sunita Shakya;Ann Gruber-Baldini
本横断面研究的目的是比较医学合并症、认知和年龄对帕金森病（PD）患者报告结局的独立贡献。方法572例PD患者完成了患者报告结局测量信息系统（PROMIS®）-29 v2.0 Profile（身体功能、焦虑、抑郁、疲劳、睡眠障碍、对参与社会角色的满意度，疼痛干扰）和PROMIS全球健康（心理健康和身体健康）量表。合并症用累积疾病评定量表-老年（CIRS-G）测量，认知用蒙特利尔认知评估（莫卡）测量。多元回归模型研究了9 PROMIS措施预测合并症，认知，和年龄，调整人口统计学和临床特征（ADRS和疾病持续时间）。认知与九个领域中的两个相关：身体功能和焦虑。年龄与五个领域相关：焦虑，抑郁，睡眠障碍，参与社会角色的满意度和整体心理健康。合并症表现出更大的影响，所有9个领域比认知或年龄（更高的标准化β系数）。医疗并发症有一个更大的影响，无论是认知或年龄的一系列病人报告的身体和心理健康领域。医学共患病是患者对其身心健康的看法的重要贡献者。
ObjectiveThe purpose of this cross-sectional study was to compare the independent contributions of medical comorbidity, cognition, and age on patient-reported outcomes in Parkinson's disease (PD).Methods572 PD patients completed the Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v2.0 Profile (physical function, anxiety, depression, fatigue, sleep disturbance, satisfaction with participation in social roles, pain interference) and PROMIS Global Health (mental health and physical health) scales. Comorbidity was measured with the Cumulative Illness Rating Scale–Geriatric (CIRS-G) and cognition with the Montreal Cognitive Assessment (MoCA). Multiple regression models examined the 9 PROMIS measures as predicted by comorbidity, cognition, and age, adjusting for demographic and clinical characteristics (UPDRS and disease duration).ResultsComorbidity was associated with poorer outcomes in all nine PROMIS domains. Cognition was associated with two of nine domains: physical function and anxiety. Age was associated with five domains: anxiety, depression, sleep disturbance, satisfaction with participation in social roles, and global mental health. Comorbidity showed greater effects on all nine domains than cognition or age (higher standardized beta coefficients).ConclusionMedical comorbidity, cognition, and age have different impacts on patient-reported outcomes in PD. Medical comorbidity has a greater impact than either cognition or age on a range of patient-reported physical and mental health domains. Medical comorbidity is an important contributor to the patient's perspective of their physical and mental health.