Abstract

Background:

Little is known about the burden of parkinsonism and Parkinson’s disease (PD) in Latin America. Better understanding of health service use and clinical outcomes in PD is needed to improve its prognosis.

Objective:

The aim of the study was to estimate the burden of parkinsonism and PD in six Latin American countries.

Methods:

12,865 participants aged 65 years and older from the 10/66 population-based cohort study were analysed. Baseline assessments were conducted in 2003–2007 and followed-up 4 years later. Parkinsonism and PD were defined using current clinical criteria or self-reported diagnosis. Logistic regression models assessed the association between parkinsonism/PD with baseline health service use (community-based care or hospitalisation in the last 3 months) and Cox proportional hazards regression models with incident dependency (subjective assessment by interviewer based on informant interview) and mortality. Separate analyses for each country were combined via fixed effect meta-analysis.

Results:

At baseline, the prevalence of parkinsonism and PD was 7.9% (n = 934) and 2.6% (n = 317), respectively. Only parkinsonism was associated with hospital admission at baseline (OR 1.89, 95% CI 1.30–2.74). Among 7,296 participants without dependency at baseline, parkinsonism (HR 2.34, 95% CI 1.81–3.03) and PD (2.10, 1.37–3.24) were associated with incident dependency. Among 10,315 participants with vital status, parkinsonism (1.73, 1.50–1.99) and PD (1.38, 1.07–1.78) were associated with mortality. The Higgins I² tests showed low to moderate levels of heterogeneity across countries.

Conclusions:

Our findings show that older people with parkinsonism or PD living in Latin America have higher risks of developing dependency and mortality but may have limited access to health services.

中文翻译：

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拉丁美洲帕金森症和帕金森病对卫生服务使用和结果的负担

摘要

背景：

人们对拉丁美洲帕金森病和帕金森病 (PD) 的负担知之甚少。需要更好地了解帕金森病的卫生服务使用和临床结果，以改善其预后。

客观的：

该研究的目的是估计六个拉丁美洲国家帕金森病和帕金森病的负担。

方法：

对 10/66 基于人群的队列研究中 12,865 名 65 岁及以上的参与者进行了分析。基线评估于 2003 年至 2007 年进行，并于 4 年后进行随访。帕金森症和帕金森病是使用当前的临床标准或自我报告的诊断来定义的。Logistic 回归模型评估了帕金森病/PD 与基线卫生服务使用（过去 3 个月内基于社区的护理或住院治疗）之间的关联，以及 Cox 比例风险回归模型与事件依赖性（访谈者根据知情者访谈进行的主观评估）和死亡率之间的关联。通过固定效应荟萃分析合并每个国家的单独分析。

结果：

基线时，帕金森症和 PD 的患病率分别为 7.9% ( n  = 934) 和 2.6% ( n  = 317)。只有帕金森病与基线入院相关（OR 1.89，95% CI 1.30-2.74）。在 7,296 名基线时没有依赖性的参与者中，帕金森病（HR 2.34，95% CI 1.81–3.03）和 PD（2.10，1.37–3.24）与事件依赖性相关。在 10,315 名具有生命状态的参与者中，帕金森病 (1.73, 1.50–1.99) 和 PD (1.38, 1.07–1.78) 与死亡率相关。Higgins I ²测试显示各国之间存在低至中等水平的异质性。

结论：

我们的研究结果表明，生活在拉丁美洲的帕金森病或帕金森病老年人出现依赖性和死亡的风险较高，但获得医疗服务的机会可能有限。