中国四省55岁及以上人群帕金森病前驱期现状及人口经济学特征

Prodromal Parkinson's disease and its socio-demographic characteristics among people aged 55 and above in four provinces of China

  • 摘要:
    背景 近年来,中国老龄化进程加快,帕金森病的患病形势日益严峻,其疾病前期阶段及相关影响因素的研究日益受到关注。
    目的 了解中国四省55岁及以上人群的帕金森病前驱期(pPD)现状,并探讨人口学特征和社会经济状况对pPD的影响。
    方法 利用“神经系统疾病专病社区队列研究”2020年调查数据,选取具有完整人口学和社会经济学信息、帕金森病风险因素筛查数据的10724名55岁及以上研究对象。依据国际帕金森病和运动障碍协会研究标准评估研究对象的pPD风险水平(即后验概率)、可能或极可能的pPD检出率及相关风险/前驱标志数。分别采用多重线性回归模型和多因素logistic回归模型分析人口经济因素与pPD风险水平和可能或极可能的pPD的关系;采用Poisson回归模型和多项logit回归模型分析人口经济因素与pPD风险/前驱标志数的关联并对性别进行分层分析。
    结果 2020年中国四省55岁及以上人群pPD后验概率的中位数(P25P75)水平为0.78%(0.42%,1.66%),可能或极可能的pPD检出率为0.34%,有69.03%的研究对象具有3~5个pPD风险/前驱标志。男性、年龄越高、文化程度越低、家庭人均月收入<1000元、居住在城市、无工作者的pPD后验概率较高(P<0.05);男性和≥75岁者可能或极可能的pPD检出率高于其他组(P<0.05)。≥75岁人群检出可能或极可能的pPD的可能性高于55~64岁组(OR=8.404,95%CI:2.839~24.879)。男性、无工作者、低文化程度者、高龄老人及城市居民出现pPD风险/前驱标志的可能性高于相应的特征人群(P<0.05)。
    结论 我国四省55岁及以上人群中男性、≥75岁、文化程度低、居住在城市以及无工作者的pPD风险水平更高并更有可能出现风险/前驱标志,经济状况较差也与较高的pPD风险水平相关。

     

    Abstract:
    Background China is witnessing an accelerated aging process and an increasingly serious situation of Parkinson's disease. Research on the pre-disease stage and its related influencing factors has gained more and more attention.
    Objective To analyze the current situation of prodromal Parkinson's disease (pPD) of people aged 55 years and above in four provinces of China, and to explore its influencing demographic and socio-economic characteristics.
    Methods Using the data of Community-based Cohort Study on Nervous System Disease in 2020, a total of 10724 participants with complete data on demographic and socio-economic factors and risk factors on Parkinson's disease were selected. Based on the criteria recommended by the International Parkinson and Movement Disorder Society (MDS), we evaluated risk level (i.e., post-test probability) of pPd, prevalence of possible or probable pPD, and number of pPD-related risk/prodromal markers in the participants. Multiple linear regression and multiple logistic regression models were used to analyze the influencing socio-demographic factors of risk level of pPd and prevalence of possible or probable pPD, and Poisson regression and multinomial logit regression models were used to analyze the influencing socio-demographic factors of the number of pPD-related risk/prodromal markers in the total sample, men, and women, respectively.
    Results The median (P25, P75) of post-test probability of pPD in 2020 was 0.78% (0.42%, 1.66%), the prevalence rate of possible or probable pPD was 0.34%, and 69.03% of the participants reported 3-5 pPD-related risk/prodromal markers. The post-test probabilities of men, those with older age, lower education level, per capita monthly household income < 1000 yuan, urban residency, or without active employment were higher (P<0.05). Men and being aged ≥ 75 years had a higher prevalence of possible or probable pPD (P<0.05). The OR of possible or probable pPD was 8.404 (95%CI: 2.839−24.879) in subjects aged ≥ 75 years versus those aged 55−64 years. Males, those without active employment, being less educated, with older age, and urban residents were more likely to report pPD-related risk/prodromal markers than those of the opposite groups (P<0.05).
    Conclusion Men, subjects aged ≥75 years, those with lower education level, urban residents, and those without active employment have higher risk levels of pPD and are more likely to report pPD-related risk/prodromal markers among people aged 55 years and above in the four provinces of China, poor economic situation is also associated with higher risk levels of pPD.

     

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