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Objective:To explore the diagnostic value of the serial position effect combined with delayed recall of auditory verbal learning test in diagnosing the elderly patients with different levels of cognitive impairment.Methods:A total of 310 subjects were enrolled and divided into three groups: the normal control group(NC group, n=128), the mild cognitive impairment group(MCI group, n=133)and the mild Alzheimer's disease group(mild AD group, n=149)matched for gender, age and education level.Comprehensive neuro-psychological tests were performed on all subjects, and the Auditory Verbal Learning Test-Huashan version(AVLT-H)was used to analyze the serial position effect.Results:There were significant differences in the primacy effect of the second and third time of immediate recall, short-term and long-term delayed recall among the three groups( P<0.05), but no difference was found in the recency effect between the MCI and mild AD groups( P>0.05). The long-term delayed primacy effect combined with the short-term delayed recall showed a better validity to distinguish those elderly subjects with different levels of cognitive impairment than other memorial indexes, and the correlative sensitivity and specificity were 83.21% and 71.43%(NC group vs.MCI group), 85.71% and 92.86%(NC group vs.mild AD group), 66.67% and 75.57%(MCI group vs.mild AD group), respectively. Conclusions:The long-term delayed primacy effect combined with the short-term delayed recall can assist in distinguishing elderly patients with different levels of cognitive impairment.
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Objective@#To investigate the prevalence characters of peripheral artery disease (PAD) and associated factors among people aged 35 and above in Beijing.@*Methods@#This was a cross-sectional study. A total of 5 208 community-based individuals aged equal and above 35 in Beijing were chosen with stratified multistage random sampling method. Structure questionnaire was used to collected the information of demographic factors, habits and chronic disease history. Ankle brachial blood pressure was detected and ankle brachial index (ABI) was calculated. ABI was used to diagnose PAD (ABI≤0.90). Based on the 2010 Beijing Municipal Population Census, the age-and gender-specific weight-adjusted sample was acquired to estimate the prevalence of PAD and corresponding 95% confidence intervals (CI). Multivariate logistic regression analysis was performed to estimate the associated factors of PAD.@*Results@#The age-and sex-standardized prevalence of PAD was 3.84% (200/5 208, 95%CI 3.32%-4.36%). There was no significant difference between male and female (3.83%(102/2 664, 95%CI 3.10%-4.56%) vs. 3.85% (98/2 544, 95%CI 3.10%-4.60%), P=0.965). The prevalence of PAD in urban was higher than that in rural (4.34% (163/3 755, 95%CI 3.69%-4.99%) vs. 2.55% (37/1 453, 95%CI 1.74%-3.36%), P=0.001). Furthermore, the prevalence of PAD increased with age (Ptrend<0.01), and the difference between genders did not change with ageing (all P>0.05). In addition, age (OR=1.03, 95%CI 1.01-1.04), urban (OR=1.52, 95%CI 1.08-2.12), smoking (OR=1.83, 95%CI 1.29-2.59), hypertension (OR=1.61, 95%CI 1.17-2.22) and diabetes (OR=1.44, 95%CI 1.08-1.93) were related with increased risk of PAD in logistic regression analysis models.@*Conclusions@#The prevalence of PAD increases with age in Beijing and there are significant difference between urban and rural on prevalence of PAD. Age, urban, smoking, hypertension and diabetes are related with increased risk of PAD.
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Objective To investigate the prevalence and risk factors of H-type hypertension among middle-aged and elderly people in Beijing community. Methods A cross-sectional study by recruiting 1 458 middle-aged and elderly people from a cohort of the "Beijing Longitudinal Study of Aging" in 2009 was conducted. All participants were asked to complete a standardized questionnaire, physical examination and laboratory examinations. Hyperhomocysteinemia was defined as homocysteine (Hcy) > 15 μmol/L, and H- type hypertension was defined as having hypertension and hyperhomocysteinemia simultaneously. The prevalence of H-type hypertension was estimated by using the results of 2000 Beijing population census to weight the data. Multivariate Logistic regression analysis was preformed to estimate the associated factors of H-type hypertension. Results The age was (69.48 ± 8.09) years, and the distribution of Hcy was skewed with the median of 16.56 μmol/L. After weight, the prevalence of hyperhomocysteinemia was 57.20% (834/1 458), and the prevalence of H-type hypertension was 35.32% (515/1 458), accounting for 59.47% (515/866) in patients with hypertension. The ageing, male, hyperuricemia, estimated glomerular filtration rate (eGFR) and insufficiency of fishes/ shrimps were independent risk factors of H-type hypertension ( OR = 2.30, 1.04, 1.02, 0.95 and 0.67; 95% CI 1.54-3.44, 1.02-1.06, 1.04-1.06, 0.94-0.97 and 0.46-0.97; P＜0.01 or＜0.05). Conclusions The proportion of H-type hypertension is high in the middle-aged and elderly people in Beijing community. Lowering uric acid, protection of renal function and intake sufficient fishes and shrimps might prevent and control H-type hypertension.
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Objective To find out the prevalence of urinary incontinence(UI),as well as its impact on self assessed life quality in community dwelling elderly Beijing residents.Methods A total of 2 878 local elderly residents(≥ 65 years)were enrolled through stratified cluster random sampling from July 2013 to December 2014 in Beijing.A face-to-face questionnaire survey and physical examination were conducted by trained investigators.UI was screened using ICIQ SF.Prevalence of UI was adjusted by the standard population of Beijing and the number of elderly people with UI was estimated.Results The overall prevalence of UI was 24.6％.The morbidity of UI was 18.5％ in male and 29.8％ in female participants.The estimated number of elderly UI patients in Beijing was about 445 thousands,with 153 thousand male and 292 female patients.After adjustment for potential confounding demographic,lifestyle and chronic disease factors,logistic regression analysis revealed that UI was negatively correlated with several self-assessed measures,including quality of life,health,sleep quality,activities of daily life,sexual life and relationship with other people(all P＜0.05).Moreover,negative emotions in the last four weeks increased in the elderly with UI.Conclusions Nearly one quarter of the aged population,especially among aged women,in Beijing suffer from UI.UI severely affects the quality of life and emotions in aged persons.It is necessary to take early interventions to improve quality of life and promote healthy aging.
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Objective To investigate the rates on prevalence,awareness,treatment and control of hypertension in population older than 15 years of age in Beijing,2013-2014.Methods A cross-sectional survey was conducted in Beijing between 2013-2014.Stratified multistage random sampling method was used to select representative sample of 13 057 Chinese individuals aged over 15 years,from the general population.Blood pressure was measured for three readings at sitting position after resting for at least five minutes with an average reading recorded.A standardized structured questionnaire was developed to collect history of hypertension and antihypertensive treatment.Results A total of 4 663 community residents aged over 15 years were hypertensive among the 13 057 individuals,with the standardized prevalence rate as 32.7％,in Beijing area.The age-standardized prevalence rates of hypertension appeared 34.6％ in men and 30.8％ in women.The age-and sexstandardized prevalence of hypertension rates were 33.3％ in urban and 24.6％ in rural areas.The prevalence of hypertension increased with age and appeared higher in men than in women,in urban than in rural residents.Among the hypertensive patients,rates of awareness,treatment and control were 66.8％,64.6％ and 31.6％,respectively.Conclusion High prevalence of hypertension with low rates on awareness and treatment and control,appeared in the general population of Beijing.Related strategies should be developed regarding prevention,control and management of hypertension,to reduce the burden of this disease.
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Objective To investigate the rates on prevalence,awareness,treatment and control of hypertension in population older than 15 years of age in Beijing,2013-2014.Methods A cross-sectional survey was conducted in Beijing between 2013-2014.Stratified multistage random sampling method was used to select representative sample of 13 057 Chinese individuals aged over 15 years,from the general population.Blood pressure was measured for three readings at sitting position after resting for at least five minutes with an average reading recorded.A standardized structured questionnaire was developed to collect history of hypertension and antihypertensive treatment.Results A total of 4 663 community residents aged over 15 years were hypertensive among the 13 057 individuals,with the standardized prevalence rate as 32.7％,in Beijing area.The age-standardized prevalence rates of hypertension appeared 34.6％ in men and 30.8％ in women.The age-and sexstandardized prevalence of hypertension rates were 33.3％ in urban and 24.6％ in rural areas.The prevalence of hypertension increased with age and appeared higher in men than in women,in urban than in rural residents.Among the hypertensive patients,rates of awareness,treatment and control were 66.8％,64.6％ and 31.6％,respectively.Conclusion High prevalence of hypertension with low rates on awareness and treatment and control,appeared in the general population of Beijing.Related strategies should be developed regarding prevention,control and management of hypertension,to reduce the burden of this disease.
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Objective To discuss the relationship between food habits and hyperhomocysteinemia (HHcy), and provide dietary intervention basis for the aged in prevention and cure of HHcy. Methods Participants coming from the cohort of the Beijing Longitudinal Study of Aging in 2009, were asked to complete a food habits questionnaire and underwent laboratory examinations, including total homocysteine and blood biochemical item. According to effects of food on metabolism of Hcy, the commonly used foods were divided into three kinds: (1)Rich in VitB12 or folic acid or betaine:chicken or duck egg, pork or beef or lamb, bean products and vegetables.(2)Rich in VitB6: fish or shrimp, milk and chicken or duck. (3)Rich in antioxidant: fresh fruit, tea and coffee. According to the intake of frequency, each food was divided into"often eat"and"not often eat"or"not eating". HHcy was defined as>15μmol/L, Logistic regression analysis was used to analyze the association between dietary intake and HHcy, after adjusting confounding factors. Results The prevalence of HHcy was 61.9%(902/1458);accordi ng to the results, for the patients who do not often eat or not eat food rich in VitB12 or folic acid or betaine (chicken or duck egg, bean products and pork or beef or lamb) and VitB6 (fish or shrimp and milk), the risk of HHcy was significantly increased. After adjusting for multiple factors, the risk was still significantly increased, P<0.05. Conclusions Not often eating chicken or duck egg(less than once a day), bean products(less than once a week), fish or shrimp(less than twice a month) and not eating pork or beef or lamb or milk, were independtly associated with the increasing risk of HHcy in elderly people.
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Objective To investigate the risks of self-rated health in the ≥55-year elderly in Beijing and the occurrence of stroke.Methods The subjects (n=2 101;aged ≥55) from Beijing longitudinal study of aging (BLSA) were collected by Xuanwu Hospital,Capital Medical University from January 1992 to December 2016.One hundred and twenty-one subjects with stroke at baseline and 92 with incomplete information were excluded,and finally,1 888 elderly patients without cerebrovascular disease at baseline were included in the analysis.Based on the actual situation,the self-rated health was to identify an item that matched their current state from good,general to poor.The deadline for the survey was December 31,2012.The competitive risk model was used to assess the health self-rated status and the risk of stroke.Non-stroke deaths,including cancer and car accidents were treated as competitive events.Results Of the 1 888 subjects enrolled,946 (50.1%) self-rated health were good,616 (32.6%) were general,and 326 (17.3%) were poor;438 (23.2%) had stroke,751 (37.8%) had non-stroke death,and 699 (37.0%) were right censored data.Using the competing risk model and adjusting the age,sex,living area,marital status,education level,smoking,alcohol consumption,physical exercise,hypertension,diabetes mellitus,coronary heart disease,and body mass index,the occurrence of stroke in patients with poor self-rated health was 1.44 times (95%CI 1.11-1.87,P<0.01) as good as those who were good.Conclusion In the self-rated health of the elderly ≥55 years old in Beijing,the people with poor self-rated health increased the occurrence of stroke after considering the competitive risks.
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Objective To analyze the effect of stroke duration on the cognitive function in the elderly population in Beijing.Methods Based on the Research Project of Beijing Chronic Disease Combined with Common Elderly Syndrome Community Management Practices,a cross-sectional study was used.From July 2013 to December 2014,the old population in 4 districts and a county (Xicheng District,Fangshan District,Tongzhou District and Yanqing County) in Beijing were sampled with the multi-stage,randomized and stratified sampling.A total of 3 024 subjects were enrolled in the study.The data were obtained from the questionnaires and clinical examinations.Mini-Mental State Examination (MMSE) was used as the evaluation index of cognitive function.The subjects were divided into either a normal cognitive function group (MMSE>26,n=1 878) or a cognitive impairment group (MMSE≤26,n=1 146) according to the MMSE scores.A multiple logistic regression model was used to analyze the effects of hemorrhagic stroke,ischemic stroke,and asymptomatic stroke,as well as disease duration on cognitive function.Results After adjusting for the confounding factors,such as sex,age,educational level,marriage,smoking,and alcohol consumption,the risks of occurring cognitive impairment in patients with hemorrhagic stroke in stroke duration for 1-3,4-10 and >10 years were OR 3.019 (95％CI 0.974-9.361,P=0.056),8.652 (95％CI 2.924-25.601,P10 years were 1.000 (95％CI 0.636-1.571,P=1.000),1.874 (95％CI 1.231-2.853,P=0.003),2.439 (95％CI 1.386-4.291,P=0.002) times of those without occurring stroke population.Stroke duration for 4-10 years in patients with hemorrhagic stroke and stroke duration for 4-10 and >10 years in patients with ischemic stroke were all the risk factors for occurring cognitive dysfunction.Conclusion For patients with stroke,stroke duration or long-term effects has a certain impact on cognitive function.
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Objective To discuss the relationship between food habits and hyperhomocysteinemia (HHcy), and provide dietary intervention basis for the aged in prevention and cure of HHcy. Methods Participants coming from the cohort of the Beijing Longitudinal Study of Aging in 2009, were asked to complete a food habits questionnaire and underwent laboratory examinations, including total homocysteine and blood biochemical item. According to effects of food on metabolism of Hcy, the commonly used foods were divided into three kinds: (1)Rich in VitB12 or folic acid or betaine:chicken or duck egg, pork or beef or lamb, bean products and vegetables.(2)Rich in VitB6: fish or shrimp, milk and chicken or duck. (3)Rich in antioxidant: fresh fruit, tea and coffee. According to the intake of frequency, each food was divided into"often eat"and"not often eat"or"not eating". HHcy was defined as>15μmol/L, Logistic regression analysis was used to analyze the association between dietary intake and HHcy, after adjusting confounding factors. Results The prevalence of HHcy was 61.9%(902/1458);accordi ng to the results, for the patients who do not often eat or not eat food rich in VitB12 or folic acid or betaine (chicken or duck egg, bean products and pork or beef or lamb) and VitB6 (fish or shrimp and milk), the risk of HHcy was significantly increased. After adjusting for multiple factors, the risk was still significantly increased, P<0.05. Conclusions Not often eating chicken or duck egg(less than once a day), bean products(less than once a week), fish or shrimp(less than twice a month) and not eating pork or beef or lamb or milk, were independtly associated with the increasing risk of HHcy in elderly people.
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In this article,we gave a detail description on the experience of teaching evidence-based medicine (EBM) in undergraduate students and graduate students as well as for continue medical education.The staff of Department of EBM was from variety of sub-discipline,including epidemiologists,physicians,surgeons and librarian.To make the course smoothly,the member of the department discussed the plan together frequently,and had conduct test lecture,which make the course to become perfect.The key for the development in our department is powerful organization and leadership,pursuing perfect,keeping with the progress of the EBM and team-working.
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The paper described the concept of evidence-based medicine and its guiding role in clini-cal practice and scientific research. It emphasized the importance of teaching evidence-based medicine in clinical medicine teaching of medical college students, and put forward some suggestions on how to carry out evidence-based medicine teaching among undergraduate students. In the course of undergraduate study, students should have preliminary grasp of how to apply the theory of clinical epidemiology to evaluate the evidence of clinical research so that they could evaluate the authenticity, importance and applicability of the research evidence . Besides , they could correctly understand and apply the evidence of evidence-based medicine in clinical practice in the future, and at the same time cultivate their scientific research thinking and innovative ability.
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Since the chronic kidney disease (CKD) and end-stage renal disease (ESRD) can cause serious disease burden and consume huge amounts of health resources to human life,research on CKD received increasing attention.For the particularity of the elderly,whether the current definition,stages and renal function assessment of CKD should be distinguished from the adults has been controversial.We conducted a comprehensive review on these issues.Furthermore,the studies on the epidemiologic status,trends,and characteristics of CKD for the elderly were summarized,and possible reasons for the differences between the various studies were analyzed.
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<p><b>OBJECTIVE</b>To observe the association between high-density lipoprotein cholesterol (HDL-C) level and rate of ischemic stroke recurrence.</p><p><b>METHODS</b>A total of 1 059 patients with ischemic stroke were enrolled from 5 community health centers and underwent baseline surveys during the period of January 2003 to December 2006. After baseline surveys, patients were followed up every 6 months until December 31, 2008. The new stroke events were recorded as the primary study endpoint. The association between HDL-C, HDL-C/TC and ischemic stroke recurrence was analyzed by Cox regression analysis.</p><p><b>RESULTS</b>The proportions of stroke patients with high ( ≥ 1.55 mmol/L), moderate (1.04-1.54 mmol/L) and low (<1.04 mmol/L) HDL-C levels were 15.58% (165/1 059) , 54.58% (578/1 059) and 29.84% (316/1 059) respectively. During a mean of (3.21 ± 1.04) years follow-up, recurrent ischemic stroke was recorded in 137 patients. Compared with HDL-C ≥ 1.40 mmol/L group, multivariate Cox regression analysis showed that stroke recurrence rates of patients with HDL-C ≤ 1.00 mmol/L and ranged from 1.01 to 1.19 mmol/L increased by 0.944 (HR = 1.944, 95%CI:1.033-3.659, P = 0.039) and 1.027 (HR = 2.027, 95%CI:1.116-3.682, P = 0.020)fold , respectively. Recurrence rates increased 1.237 (HR = 2.237, 95%CI:1.208-4.144, P = 0.010) fold in patients with HDL-C/TC ≤ 0.19 mmol/L compared to patients with HDL-C/TC ≥ 0.28 mmol/L.</p><p><b>CONCLUSION</b>The risk of ischemic stroke recurrence increases with decreasing HDL-C level or HDL-C/TC ratio.</p>
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Aged , Female , Humans , Male , Middle Aged , Cholesterol, HDL , Blood , Follow-Up Studies , Recurrence , Risk Factors , Stroke , Blood , EpidemiologyABSTRACT
Objective To investigate the relationship between serum uric acid (SUA) and metabolism syndrome (MS) in community-based elderly population in Beijing.Methods A community-based and cross-sectional survey on 1821 elderly person was performed in Beijing in 2000.Questionnaire survey,physical examination and blood biochemical tests were conducted.Relationship of MS and its components with SUA was analyzed.Results Among 1821 subjects,there were 365 cases with MS (20.0％) and 1456 cases without MS (80.0％).SUA level was higher in MS group than in non-MS group [(5.20±2.27) μmol/L vs.(4.50±1.44) μmol/L,t=-7.34,P=0.000].All subjects were divided into 4 groups according SUA level:goup 1 (≤3.5μmol/L,n=443),group 2 (3.6 μmol/L-4.4 μmol/L,n=465),group 3 (4.5 μmol/L-5.4 μmol/L,n=446) and group 4 (≥5.5 μmol/L,n=467).SUA level was increased along with the increased BMI,TG,TC,LDL-C levels,and decreased along with the decreased HDL-C level,which had significant differences (F=43.07,9.32,22.36,8.19,9.39,all P＜0.001).There were significant distribution differences in MS components numbers in the 4 groups (x2=73.62,P=0.000).After adjusting for age,sex,residential,education level,marriage,smoking,drinking and exercise habits,logistic regression analysis showed that MS was related with SUA level,and the risk of MS was increased along with the increased SUA level.Conclusions MS is correlated with SUA level in elderly people.SUA level should be observed and controlled effectively in the elderly.
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Objective To investigate the prevalence,characteristics and risk factors of fatigue in a large cohort of subjects with early Parkinson's disease (PD).Methods A total of 391 individuals with PD,recruited in Linzhi trial,were re-screened.Early,non-depressed subjects [Center for epidcmiological survey depression scale (CES-D)＜16]underwent further fatigue assessment.Subjects who scored＞4 on fatigue severity scale (FSS) were classified as fatigue.Motor symptoms and PD severity were assessed using the unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr scale.Other clinical measures,including sleep disorder by Pittsburg sleep quality index (PSQ-Ⅰ),mental function by Alzheimer's Disease assessment scale-cognitive sections (ADAS-Cog) and quality of life by medical outcomes study short form 36 (SF- 36) were also evaluated.Results Among 204 subjects who completed fatigue measures,82 (40.2％) were classified as fatigue.The fatigue group had significantly more neurological impairment by higher scores on each subsets of UPDRS including mentation (P＜0.05),activities of daily living (P＜0.01) and motor (P＜0.01),while the subjects with fatigue had worse scores on SF-36 (P＜0.01).Multiple regression analyses showed that motor subset of UPDRS was the variable that had the predictive value for FSS score.The full model explained 6.4％ of the variance of the FSSscore (β=0.039,95％CI:0.019-0.059).However,other factors,including levodopa dosage,PSQ-Ⅰ,and ADAS-Cog score did not significantly contribute to the model.Conclusions Fatigue is a frequent symptom in carly,non-depressed patients with PD,affecting over 40％ of the patients in this cohort.The small correlation between fatigue and motor score,and the lack of association with dosage of dopaminergic treatment suggest that dopaminergic pathways might be only moderately involved in pathogenesis of fatigue.
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Objective To estimate the prevalence and related risk factors of post-stroke depression (PSD) in ischemic stroke survivors from community-based medical centers in urban areas of Beijing.Methods Five community-based medical centers in urban areas of Beijing were selected.Patients with first-ever or recurrent ischemic stroke were evaluated from January 2003 to December 2006. The prevalence of PSD was evaluated by Self-Rating Depression Scale (SDS), and the information on the onset of stroke, vascular risk factors and living style was also collected.Results Totally 1089 stroke patients were registered, 1074 cases among which had complete information and met inclusion criteria. The mean age of the patients was (65.0 ± 8.9) years with a median stroke course of 13.0 months. The overall prevalence of PSD was 49.9% (536/1074), and the proportions of mild, moderate and major PSD were 52.2%, 36.0% and 11.8%, respectively. There were no significant differences in prevalence of PSD among different stages of stroke and the prevalence of PSD was 51.3% within 6 months after stroke onset, 47. 1% during 6-18 months and 53.2% after 18months. Low education, activities of Daily Living (ADL) dependence, cognition impairment and recurrence of stroke were independent risk factors for PSD.Conclusions The prevalence of PSD among ischemic stroke patients is higher in community-based medical centers, but most of PSD patients are mild or moderate. More effective early intervention should be adopted to decrease PSD,promote the recovery of neural function and improve their quality of life.
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Objective To study the association of prevalence of cardio-cerebro vascular diseases (CCVD) with metabolic syndrome (MS) defined by different criteria in middle and aged people.Methods A cross-section survey was conducted among 1458 people aged 55 years and over in urban and rural areas of Beijing in 2009.MS definitions by World Health Organization (WHO),National Cholesterol Education Program-Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ ) revised,international diabetes mellitus (IDF) and Chinese Diabetes Society (CDS) were applied to analyze the association MS with the prevalence of CCVD.Results The risks of CCVD were all significantly higher in patients with MS than with non-MS using 4 definitions of MS.The definitions of WHO and CDS showed well agreement with the prevalence of CCVD.OR values of MS for CCVD were 2.14 folds (95％ CI:1.59-2.87) for WHO definition and 1.91 folds (95％ CI:1.43-2.55) for CDS definition,while OR values of MS for CCVD were 1.68 folds (95％ CI:1.32-2.15) for NCEP-ATPⅢ definition and 1.64 folds (95％ CI:1.26-2.13) for IDF definition as compared to non-MS,respectively.After adjustment for age,sex,region,history of smoking and alcohol drinking,the OR values in above four definitions were 1.91,1.88,1.67 and 1.80,respectively.The OR value of MS was highest for stroke by CDS definition and highest for coronary heart disease by WHO definition.Conclusions MS values defined by WHO and CDS are the optimal index of prevalence for CCVD in middle and aged people.
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Objective To investigate the characteristics of health related quality of life(HR-QOL) in Chinese patients with early Parkinson' s disease(PD), to identify the motor and non-motor factors that are associated with a poorer quality of life in patients with early PD. Methods All 391 patients with early PD were identified in a clinical-based study. Motor functions were measured by Unified Parkinson' s Disease Rating Scale (UPDRS) and Hoehn-Yabr Scale. Non-motor variables were assessed by Center of Epidemiological Survey Depression Scale (CES-D) for depressive symptoms, Pittsburg Sleep Quality Index (PSQI) for sleep disturbance, Fatigue Severity Scale (FSS) for fatigue, Alzheimer' s Disease Assessment Scale-Cognitive Sections (ADAS-Cng) for cognitive function, and Constipation Severity Scale for constipation. HR-QOL was measured by SF-36. Motor and non-motor variables were collected at the baseline assessment of a clinical trial and determined during a structured interview and by clinical examination by movement disorder specialists. The results were compared with those in healthy elderly people. Multiple regression analyses were used to determine which variables were strongly associated with lower levels of quality of life. Results Patients with early PD had a lower score on all dimensions of SF-36, except bodily pain dimension. Motor factors, particular physical disability and disease severity, contributed to decreased HR-QOL, but to a lesser extent. The motor score of the UPDRS (23. 8±11.8), Hoehn-Yahr stage(2. 0± 0.7), together with the rigidity score (4.4 ± 3.1), only accounted for 18.9 % (R2=0. 189) of the variance of SF-36 total score. The variables that most strongly predicted a low total SF-36 score were non-motor factors, particularly depressive symptoms, sleep disorders and fatigue. When the CES-D, FSS, and PSQI score were included in the model, the R2 increased from 0. 189 to 0.617, indicating that 61.7% of the variance in HR-QOL could be explained if additional CES-D, FSS and PSQI scores were known. Depressive symptoms, as measured by CES-D, had an overwhelming impact on HR-QOL. When CES-D score was included, the R2 change was 0.433, which indicated that additional 43.3% of the variability in HR-QOL could be explained by adding depressive symptoms. Conclusions PD has a substantial impact on HR-QOL, even if in its early stage. Depressive symptoms, sleep disorders and fatigue correlated strongly with lower quality of life. Depressive symptoms appeared to be the strongest determinant of HR-QOL in early PD patients. Every effort should be made to recognize and treat these conditions, thus improving all aspects of PD and giving these patients as good a quality of life as possible.
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Objective To evaluate the effects of Deng Zhan Sheng Mai (DZSM) capsule, a compound made of Chinese herbs, on secondary and tertiary prevention of ischemic stroke. Methods A hospital-based randomized open-blinded clinical trial was conducted among people with a prior history of ischemic stroke. Hospitals were assigned to treatment group, in which all of the participants took DZSM capsules for 3 months, or control group, in which no DZSM capsules was administrated. The primary endpoint was the reduction of levels of blood lipids, fasting blood glucose (FBG) and fibrinogen in the 3rd month. The secondary endpoints were recurrence of stroke, incidence of cardiovascular event (CVD) and all-cause mortality in the 18th month. Results 495 people were enrolled in the treatment group and 504 in the control group, respectively. In the 3rd month, the levels of total cholesterol(TC),FBG and fibrinogen were significantly reduced by 1.7%,4.3 and 8.2%(t values were 4.13,6.65 and 8.50 respectively),and the levels of HDL-C and HDL-C/TC were increased by 7.6%and 1 1.6%(t values were 2.15 and 3.67)in the treatment group, respectively(all P＜0.05＝.The levels of TC,HDL-C and HDL-C/TC decreased significantly in the eontrol group(all P＜0.05＝.The incidence of recurrent stroke and CVD events were lower in the treatment group than those in the control group, but the differences did not reach the significant levels. The prevalence of post-stroke depression (PSD) was also decreased in the 3rd mouth while it remained stable in the controls (P for trend equals to 0.0027). The mortality was significantly lower in the treatment group (P=0.008). Conclusion The levels of TC,FBG and fibrinogen as well as the prevalence of PSD and all-cause mortality have decreased significantly in treatment group treated with DZSM capsule for 3 months as compared with the control group.