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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Psychosocial risk factors, pre-motor symptoms and first-time hospitalization with Parkinson's disease: A prospective cohort study
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Psychosocial risk factors, pre-motor symptoms and first-time hospitalization with Parkinson's disease: A prospective cohort study

机译：心理社会风险因素，运动前症状和帕金森氏病首次住院：前瞻性队列研究

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Background and purpose: Experimental studies support a link between stress and development of parkinsonian symptoms, but prospective population studies are lacking. The aim of the current study is to determine the effects of several psychosocial factors on the risk of Parkinson's disease (PD), as well as to identify potential pre-motor symptoms for PD in a large prospective cohort study. Methods: In 1991-1993, a total of 9955 women and men free of PD from the Copenhagen City Heart Study were asked about major life events, economic hardship, social network, impaired sleep and vital exhaustion. The participants were followed for first-time hospitalization with PD in nationwide registers until 2011. Results: Vital exhaustion was associated with a higher risk of PD hospitalization in an exposure-dependent manner (Ptrend=0.001), with high vs. low vital exhaustion being associated with a hazard ratio of 2.50 [95% confidence interval (CI): 1.28-4.89]. A slightly higher risk of PD hospitalization (hazard ratio = 1.49; 95% CI: 0.87-2.56) was suggested in participants with impaired sleep at baseline. No more than weak associations were observed for economic hardship, major life events or inadequate social network in the current study. Conclusions: Overall, the hypothesis that psychosocial risk factors affect the risk of PD is not supported. The results, however, suggest that vital exhaustion may be a pre-motor marker of the neurodegenerative process eventually leading to motor symptoms and clinical PD. Vital exhaustion may be useful for screening aimed at early detection and when considering disease-modifying therapies in people at high risk of clinical PD.
机译：背景和目的：实验研究支持压力和帕金森症状的发展之间的联系，但缺乏前瞻性人群研究。本研究的目的是确定多种心理社会因素对帕金森氏病（PD）风险的影响，并在大型前瞻性队列研究中确定PD的潜在运动前症状。方法：在1991-1993年间，从哥本哈根市心脏研究中总共询问9955名无PD的男女，询问他们的主要生活事件，经济困难，社交网络，睡眠不足和体力衰竭。在2011年之前，对参与者进行首次住院的PD住院治疗。结果：体力衰竭与PD住院的风险较高，且依赖于暴露（Ptrend = 0.001），重要的是体力消耗高与低。风险比为2.50 [95％置信区间（CI）：1.28-4.89]。建议基线时睡眠障碍的参与者发生PD住院的风险略高（危险比= 1.49; 95％CI：0.87-2.56）。在本研究中，仅观察到因经济困难，重大生活事件或社交网络不足而产生的弱关联。结论：总的来说，关于社会心理危险因素影响PD风险的假设不成立。然而，结果表明，体力衰竭可能是神经退行性过程的运动前标志物，最终导致运动症状和临床PD。体力衰竭对于进行早期发现的筛查以及在考虑临床PD高风险人群中考虑采用可改善疾病的疗法时可能会有用。

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