The path linking excessive daytime sleepiness and activity of daily living in Parkinson's disease: the longitudinal mediation effect of autonomic dysfunction.
Neurol Sci
; 43(8): 4777-4784, 2022 Aug.
Article
em En
| MEDLINE
| ID: mdl-35487997
ABSTRACT
BACKGROUND:
Excessive daytime sleepiness (EDS) and autonomic dysfunction have been verified to impair activity of daily living (ADL) in patients with Parkinson's disease (PD). Whether EDS can affect ADL in PD patients through autonomic dysfunction is still unclear. The purpose of this study is to explore the longitudinal mediation effect of autonomic dysfunction between EDS and ADL.METHODS:
Data used in this study were from six-follow-up visits of 413 patients with newly diagnosed PD from the Parkinson's Progression Markers Initiative (PPMI). We used latent growth mediation modeling (LGMM) to explore whether the autonomic dysfunction is a longitudinal mediator between EDS and ADL.RESULTS:
The results showed that as the disease progresses, EDS (P < 0.001) and autonomic dysfunction (P < 0.001) gradually worsened and ADL (P < 0.001) gradually decreased in PD patients. In addition, the more severe the patients' EDS symptom, the more worsened the symptoms of autonomic dysfunction, which result in a decrease in ADL. Both the intercept (95% CI 0.142, 0.308) and the slope (95% CI 0.083, 0.331) of autonomic dysfunction showed a partial mediating effect, and a longitudinal mediation effect was presented.CONCLUSION:
Longitudinal changes in EDS affect the ADL of PD patients directly or indirectly by affecting the symptoms of autonomic dysfunction. Controlling the symptoms of autonomic dysfunction may improve the ADL of PD patients with EDS.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Doenças do Sistema Nervoso Autônomo
/
Distúrbios do Sono por Sonolência Excessiva
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article