1月2日,，據(jù)《每日科學(xué)》報道,，根據(jù)發(fā)表于JAMA/Archives期刊--Archives of Neurology2012年1月期上的一則報告,，人口統(tǒng)計學(xué)和臨床因素似乎與帕金森?。≒D）患者的生存相關(guān),，老年癡呆癥的存在與死亡率的顯著增加相關(guān),。
雖然帕金森病是在老年人中是一種常見的神經(jīng)退行性疾病,，在患者的存活率和疾病之間卻存在相沖突的數(shù)據(jù)，根據(jù)這篇文章中的背景信息,。
Allison W.Willis,，醫(yī)學(xué)博士，來自于圣路易斯華盛頓大學(xué)醫(yī)學(xué)院,，和同事們進(jìn)行了一個全國性的回顧性隊(duì)列研究,，關(guān)于2002年診斷并跟進(jìn)到2008年的患有帕金森病的13.8萬醫(yī)保受益者,。
性別和種族"顯著預(yù)測"生存，研究者注意到,。女性患者,，拉美裔或亞洲裔相對于白種人具有較低的死亡調(diào)整風(fēng)險。在這個6年-研究中,，64%帕金森患者死亡,，黑人患者具有最高的粗死亡率（66.4%），其次是白種人患者（64.6%）,、拉美裔患者（55.4%）,、亞洲裔患者（50.8%）。
在研究期限結(jié)束時,，69.6%的研究群體被診斷為老年癡呆癥,，黑人患者的頻率為最高（78.2%），其次是拉美裔患者（73.1%）,。白種人和亞洲人患者患帕金森病相對較低,，老年癡呆的發(fā)生率分別為69%和66.8%。
同時患有帕金森病和老年癡呆癥的患者比那些沒有癡呆癥的患者具有較大可能的死亡,。研究人員還注意到,，晚期帕金森病的患者經(jīng)常住院治療心血管疾病和感染，很少是治療帕金森病,。他們還指出,，生活在城市工業(yè)金屬高排放地區(qū)的帕金森患者具有較高的調(diào)整后死亡風(fēng)險，但研究人員還指出,，需要開展更多的工作來了解環(huán)境因素能否影響帕金森病或生存的過程,。
"我們的研究表明，老年癡呆癥通常發(fā)生在65歲及以上的帕金森病患者中,；這對于我們研究的變量--年齡-調(diào)整的生存有最強(qiáng)的影響,。我們的數(shù)據(jù)重點(diǎn)突出了在帕金森病患者中預(yù)防或治療老年癡呆癥的必要性，因?yàn)樗鼘ι嬗杏泻艽笥绊憽?quot;,，作者總結(jié)道,。（生物谷bioon.com）
doi:10.1001/archneurol.2011.2370
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Predictors of Survival in Patients With Parkinson Disease
A. W. Willis, M. Schootman, N. Kung, B. A. Evanoff, J. S. Perlmutter, B. A. Racette.
Objective：To determine the life expectancy of patients with Parkinson disease (PD) in the United States and identify demographic, geographic, and clinical factors that influence survival. Design：Retrospective cohort study of 138 000 Medicare beneficiaries with incident PD who were identified in 2002 and followed up through 2008. Main Outcome Measures：Confounder-adjusted 6-year risk of death as influenced by 3 groups of factors: (1) race, sex, and age at diagnosis; (2) geography and environmental factors; and (3) clinical conditions. We examined hospitalization diagnoses in patients with terminal PD and compared PD mortality with that of other common diseases. Results：Thirty-five percent of patients with PD lived more than 6 years. Sex and race significantly predicted survival; patients who were female (HR [hazard ratio], 0.74; 95% CI, 0.73-0.75), Hispanic (HR, 0.72; 95% CI, 0.65-0.80), or Asian (HR, 0.86; 95% CI, 0.82-0.91) had a lower adjusted risk of death than white men. Dementia, diagnosed in 69.6% of cases and most often in African American patients (78.2%) and women (71.5%), was associated with a greater likelihood of death (HR, 1.72; 95% CI, 1.69-1.75). Parkinson disease mortality was greater than that of many common life-threatening diseases. Patients with terminal PD were hospitalized frequently for cardiovascular disease (18.5%) and infection (20.9%) but rarely for PD (1.0%). Regional survival rates were similar but patients with PD living in urban high industrial metal emission areas had a slightly higher adjusted risk of death (HR, 1.19; 95% CI, 1.10-1.29). Conclusions：Demographic and clinical factors impact PD survival. Dementia is highly prevalent in patients with PD and is associated with a significant increase in mortality. More research is needed to understand whether environmental exposures influence PD course or survival.
