Risk Factors For Salivation In Parkinson's Disease

Objecttive:To expore the occurrence and severity of drooling and the relationship between drooling and related factors(age,sex,onset time,duration,daily levodopa equivalent dose(LED),severity grading,dyskinesia,and rem sleep behavior disorder(RBD),anxiety,depression,sleep at night,cognitive function)of patients with Parkinson's disease(PD).Methods:A total of 115 PD patients enrolled in this study,which were collected from the outpatient department and inpatient department of geriatric neurology of the first affiliated hospital of kunming medical universityfrom from March 2018 to January 2020.First,according to the Movement Disoder Society(MDS)clinical diagnostic criteria for Parkinson's disease in 2015,only clinically diagnosed PD patients were enrolled.Then drooling was assessed by the MDS Unified PD Rating Scale ?-2(MDS-UPDRS ?-2)and Salivated Clinical Scale-PD(SCS-PD),and survey statistical data(sex,age,onset time,duration,edaily levodopa equivalent dose(LED)and the related factors wer evaluated by the scales(PD severity grading(Hoehn-Yahr stage),the severity of dyskinesia(MDS-UPDRS ?),rem sleep behavior disorder(RBDSQ),anxiety(HAMA-17),depression(HAMD),night sleep quality(PSQI),cognitive function(MMSE).The collected data have been collated.SPSS 22.0 statistical software was used for data analysis,shapiro-wilk test(small sample)was used to test the normal distribution of continuous variables,in which the continuous variables of relevant factors conforming to the normal distribution were expressed as mean ± standard deviation(x±s),and were compared using the independent T test.The continuous variables of related factors that do not conform to the nonnal distribution were expressed as interquartile range(M(q25-q75))and analyzed by the non-parametric test(mann-whitney U test).The categorical variables were expressed as frequency(%)and were compared using the chi-square test(x2 test).Univariate and multivariate non-conditional Logistic regression models were used to assess the association between drooling and related factors in PD patients.After adjusting for important confounding factors,odds ratios(OR)and 95%confidence intervals(95%CI)were used.Spearman's rank correlation was used to analyze the relationship between risk factors(or protective factors)and drooling score,and the results were represented by rs.Both the inclusion and exclusion bounds of variables were 0.05,and P<0.05 was considered statistically significant.Results:The prevalence of drooling in this cohort was 56.48%(61/108),which males accounted for 60.7%(37/61)and females 40%(24/61),and the prevalence is high and widespread in PD.The baseline characteristics analysis of salivate group and non-salivate,there were statistically significant(p<0.05)in the differences of duration,Hoehn-Yahr stage,HAMA score,UPDRS ? score and PSQI score between the two groups,salivate group was higher than non-salivate;There were some differences in age,onset time,disease duration,daily LED,RBDSQ score,HAMD score and MMSE score between the two groups,but it was't statistical significance(p>0.05).Age,onset time,disease duration,daily LED,RBDSQ score and HAMD score in the salivate group were higher than those in the non-salivate,and MMSE score in the salivation group was lower than that in the non-salivate.In the related risk factors in the analysis,found the Hoehn-Yahr stage,HAMA scores,UPDRS ? score,PSQI score are risk factors for PD with drooling,adjust the two confounding factors of Hoehn-Yahr stage and HAMA scores,the UPDRS ?score(dyskinesia severity)and PSQI score(night sleep disorder)remained independent risk factor for PD patients with drooling,The corresponding odds ratio(OR)and 95%confidence intervals(95%CI)were 1.084(1.015-1.157)and 1.169(1.023-1.335),respectively.UPDRS ?-2 score and the SCS-PD score do not conform to the normal distribution,use the Spearman correlation analysis the relationship between UPDRS ? score(dyskinesia),PSQI score(night sleep disorder)and UPDRS ?-2 score,SCS-PD score(salivate severity),there were positive rank correlation of relationship(moderate Correlation,weak Correlation),Correlation coefficient rs are respectively 0.615(UPDRS ?&UPDRS ?-2),0.391(PSQI&UPDRS ?-2),0579(UPDRS ?-&SCS-PD),0.382(PSQI&SCS-PD).Conclusions:1.The prevalence of PD with drooling is high and widely distributed;2.The higher the UPDRS ? score(dyskinesia)and the PSQI score(night sleep disorder),the greater the chance being an independent risk factor for PD with drooling.3.The higher the UPDRS ? score(dyskinesia)and the PSQI score(night sleep disorder),the UPDRS ?-2 score and SCS-PD score(salivate severity)are higher.