| Background and objectiveParkinson's disease as the second largest neurodegenerative disease related to age,is second only to Alzheimer's disease.The incidence of Parkinson's disease has been increasing until the age of 85.There is evidence that the increase of age does directly affect the clinical manifestations of PD.The age of onset is different and the clinical characteristics are different.However,due to the lack of related studies on elderly patients with PD,they should receive more attention as a unique subgroup.Therefore,we retrospectively analyzed the clinical data of 149patients with primary PD to explore the unique clinical characteristics of elderly patients with PD,so as to provide comprehensive coping strategies for elderly patients with PD.MethodsThe detailed clinical data of 149 patients with primary PD diagnosed in our hospital from January 2018 to June 2019 were collected and recorded,including age,sex,first motor symptoms,non-motor symptoms and complications,presence or absence of wearing-off phenomenon or dyskinesia,and the use of anti-PD drugs.In this study,the age of onset was defined as the age at which motor symptoms associated with PD were first found,and they were divided into four groups:<60 years old,60 years old ? age<70 years old,70 years old?age?80 years old,and?80 years old.Among them,age<60 years old is defined as non-elderly group,60 years old?age<70 years old is defined as early elderly group,70 years old?age<80 years old is defined as late elderly group,and age? 80 years old is defined as advanced age group.SPSS22.0 was used for statistical analysis of the data.If the measurement data satisfy the normal distribution and the variance is uniform,the mean difference of multiple groups is tested by single factor analysis of variance.If the P value is less than 0.05,LSD-t is used to compare the two groups.If the P value is less than the corrected test level ?/6=0.0083,there is a significant difference between the two groups.According to the adoption rate of counting data,2-test or Fisher exact probability method was used for multiple groups of qualitative data.If P<0.05,Chi-square segmentation and Bonferroni correction method were used to adjust the test level between groups.If P value is less than the corrected test level 0.0083,the difference between the two groups is statistically significant.ResultsAmong the 149 PD patients included,there were 47 patients(31.54%)in the non-elderly group,with an average age of(51.87±4.52)years;61 patients in the early elderly group(40.94%),with an average age of(64.45±3.49)years;and 22 patients in the late elderly group(14.77%),with an average age of(72.09±4.13)years.There were 19 patients(12.75%)in the advanced age group,with an average age of(83.16±1.86)years.In the clinical features of PD:the incidence of motor retardation,RBD,severe cognitive impairment and hallucination in the advanced age group was significantly higher than that in other subgroups(P<0.0083).Ankylosis,postural imbalance,severe pain,insomnia,RLS,severe depression,constipation,postural hypotension and abnormal sweating were common in the advanced age group and the late elderly group,and there were significant differences between the elderly group and the non-elderly group and the early elderly group(P<0.0083).EDS and bladder dysfunction were common in the advanced age group and were significantly different from those in the non-elderly group and the early elderly group(P<0.0083).The incidence of wearing-off phenomenon and dyskinesia in the advanced age group was low(21.1%and 10.5%,respectively),and there was significant difference between the elderly group and the non-elderly group and the early elderly group(P<0.0083).The incidence of diabetes,pulmonary infection and skeletal muscle disease in the advanced age group was significantly higher than that in the non-elderly group and the early elderly group(P<0.0083),the cardiovascular and cerebrovascular diseases were more common in the advanced age group than those in the non-elderly group and there was significant difference between the two groups(P<0.0083),and the average daily dose of levodopa in the advanced age group was lower(398.70mg/d),and there was significant difference between the advanced age group and the non-elderly group and the early elderly group(P<0.0083).Conclusion1.Elderly patients with PD have more severe motor dysfunction,but tremor symptoms are not typical.2.Elderly patients with PD showed more and more severe non-motor symptoms.3.Elderly patients with PD have a higher burden of complications.4.Wearing-off phenomenon and dyskinesia are not common in elderly patients with PD.5.Elderly patients with PD are more likely to use low-dose levodopa monotherapy. |
PDF Full Text Request