PDF(Pubmed)
Abstract：
Loss of ambulation is common and highly variable in Parkinson\'s disease (PD), and poorly understood from the perspectives of those with PD. Gaining insights to the anticipated perceived trajectories and their drivers, will facilitate patient-centered care. Latent class growth analysis, a person-centered mixture modelling approach, was applied to 16,863 people with PD stratified by early (N = 8612; < 3 years), mid (N = 6181; 3-10 years) and later (N = 2070; > 10 years) disease to discern clusters with similar longitudinal patterns of self-reported walking difficulty, measured by EuroQoL 5D-5L that is validated for use in PD. There were four clusters in early and mid-disease strata, with a fifth identified in later disease. Trajectories ranged from none to moderate walking difficulty, with small clusters with severe problems. The percentage of subjects with moderate (early = 17.5%, mid = 26.4%, later = 32.5%) and severe (early = 3.8%, mid = 7.4%, later = 15.4%) walking difficulty at baseline increased across disease duration groups. The trajectories tended to be stable with variability in moderate and severe groups. Across strata, clusters with moderate to severe problems were associated with more severe impairment, depression, anxiety, arthritis, higher BMI, lower income, and lower education, but no consistent race or gender differences. The findings reveal distinct longitudinal patterns in perceived difficulties in walking in PD.
摘要：
在帕金森病（PD）中，步行障碍是常见且高度可变的，从PD的角度来看，人们对此知之甚少。获得对预期的感知轨迹及其驱动程序的见解，将促进以患者为中心的护理。潜在班级增长分析，以人为中心的混合建模方法，应用于16,863名PD患者，早期分层（N=8612；<3年），中期（N=6181；3-10年）和以后（N=2070；>10年）疾病，以辨别具有相似纵向模式的自我报告行走困难的集群，通过验证用于PD的EuroQoL5D-5L测量。在早期和中期疾病地层中有四个集群，在后来的疾病中发现了第五个。轨迹范围从无到中等行走困难，有严重问题的小集群。中度受试者的百分比（早期=17.5％，mid=26.4%，后期=32.5%)和重度(早期=3.8%，mid=7.4%，later=15.4%)基线时的行走难度在疾病持续时间组中增加.在中度和重度组中，轨迹趋于稳定，具有变异性。跨地层，具有中度至重度问题的集群与更严重的损害有关，抑郁症,焦虑,关节炎,BMI较高,收入较低,和较低的教育，但没有一致的种族或性别差异。研究结果揭示了PD中行走困难的明显纵向模式。
