Canadian Journal of Neurological Sciences最新文献

We present a 15-year retrospective study comparing the epidemiology of Parkinson's disease (PD) between Chinese and non-Chinese populations in the Greater Toronto Area. A cohort of 88 patients with PD revealed that Chinese patients (N = 36) had a significantly lower mean age at diagnosis (67.3 ± 12.6 years) compared to non-Chinese patients (72.1 ± 9.2 years) (p = 0.039). Higher obesity rates were found in non-Chinese patients (p = 0.0004). Chinese patients experienced more motor fluctuations (p = 0.028) and amantadine use (p = 0.041). These findings underscore the importance of future research on ethnic variations in PD.

Résultats d’une étude rétrospective, d’une durée de 15 ans, sur l’épidémiologie de la maladie de Parkinson au sein de la population chinoise au Canada, dans la région du Grand Toronto. On presente les resultats une étude rétrospective, d’une durée de 15 ans, qui visait à comparer l’épidémiologie de la maladie de Parkinson (MP) entre la population chinoise et la population non chinoise dans la région du Grand Toronto. L’Âge moyen des sujets au moment de la pose du diagnostic, dans la cohorte de 88 patients atteints de la MP, était significativement plus bas chez les Chinois (n = 36) (67,3 ± 12,6 ans) que chez les non-Chinois (72,1 ± 9,2 ans) (p = 0,039). Par contre, le taux d’obésité était plus élevé chez les sujets non chinois que chez les sujets chinois (p = 0,0004). Enfin, une fréquence accrue des fluctuations de la motricité (p = 0,028) et un usage étendu de l’amantadine (p = 0,041) ont été observés chez les patients chinois comparativement aux patients non chinois. Ces résultats soulignent l’importance de poursuivre la recherche sur les variations ethniques observées dans l’épidémiologie de la MP.

Background: Parkinson disease (PD) is a neurological disorder that affects more than 10 million people worldwide, impacting both quality of life and marital relationships. Divorce rates are higher in Western compared to Eastern countries. However, it is unclear if there are differences in marital status after PD onset between the two regions.

Methods: We searched MEDLINE and Embase from inception to March 31, 2024. Original studies discussing marital status in participants with PD were included. An unmarried status includes single, widowed, divorced or separated. Outcomes included the prevalence of being unmarried, measured as proportions, and the risk ratio (RR) of being unmarried in participants with PD relative to controls.

Results: Out of 567 studies screened initially, 55 studies involving 3,723,966 participants were included. The prevalence of being unmarried was evaluated in 55 studies (25.16%; 95% CI: 21.52-29.18). The prevalence of being unmarried was significantly higher in countries in the West compared to the East (28.83%; 95% CI: 25.09-32.89 vs 17.47%; 95% CI: 12.10-24.57, p < 0.01). Compared to controls, the risk of being unmarried in PD participants after the onset of PD was significantly higher in the East (RR: 1.21, 95% CI: 0.91-1.60) compared to the West (RR: 0.87, 95% CI: 0.65-1.15).

Conclusions: Our meta-analysis showed significantly higher rates of being unmarried in Western compared to Eastern countries. After PD onset, participants in the East were at significantly higher risk of being unmarried compared to participants in the West, suggesting that differences in cultural practices, societal norms and healthcare systems may affect marital status outcomes in PD participants.

Background: We sought to compare whether quality of life (QOL) in patients with subjective cognitive impairment (SCI) who performed normally on a neuropsychological battery significantly differed from those diagnosed with mild cognitive impairment (MCI), Alzheimer's disease (AD) or non-Alzheimer's dementia (non-AD) at initial assessment in a Rural and Remote Memory Clinic (RRMC).

Methods: 610 patients referred to our RRMC between 2004 and 2019 were included in this study. We compared self-reported and caregiver-reported patient QOL scores in those with SCI (n = 166) to those diagnosed with MCI (n = 98), AD (n = 228) and non-AD (n = 118).

Results: Patients with SCI self-reported significantly lower QOL compared to patients with AD. Interestingly, the reverse was seen in caregivers: SCI caregivers rated patient QOL higher than AD caregivers. Patients with SCI also reported lower QOL than patients with MCI. SCI caregivers reported higher patient QOL than their non-AD counterparts. Caregiver-rated patient QOL was higher in those with MCI compared to AD. Patients with MCI self-reported higher QOL scores compared to patients with non-AD dementias. Similarly, MCI caregivers reported higher patient QOL than non-AD caregivers. No other comparisons were statistically significant.

Conclusion: Although they lacked clinically significant cognitive deficits, patients with SCI self-reported significantly lower QOL than patients with MCI and AD. Conversely, caregiver-reported patient QOL was higher for patients with SCI than for patients with AD and non-AD. This shows that SCI seriously impacts QOL. More research is needed on how we can better support patients with SCI to improve their QOL.

Background: Treatment of acute ischemic stroke is highly time dependent, which relies heavily on each hospital's ability and capacity. Designated stroke centers have been established across Canada, but there is still a divide between urban and rural hospitals. This study aims to understand the similarities and differences in their stroke treatment process workflow, incorporation of best practices and data collection.

Methods: Interviews were conducted with clinicians in stroke centers across Canada to identify similarities and differences between provinces and hospital treatment capability. Semi-structured interviews were completed from September 15 to November 3, 2023, with clinicians and stroke coordinators using snowball and purposive sampling techniques. The interviews were analyzed using thematic analysis.

Results: Fourteen participants were interviewed with representatives from four primary stroke centers and three comprehensive stroke centers across five provinces. Five primary themes were identified: 1) management of resources, 2) standardization of tasks, 3) data collection, 4) tool integration into workflow and 5) teamwork and experience. Participants in primary centers described limited resources to follow the patient through the entire treatment process, reliance on pre-notification times to prospectively search necessary patient information, using software to aid in calculating National Institute of Health Stroke Scale and being more cautious toward treating thrombolytics. Both center types discussed challenges with complete and accurate data collection.

Conclusions: The overall stroke treatment process and information required across primary and comprehensive centers are similar. However, differences occur in the process due to limitations in resources, pre-arrival notification time, completeness and accuracy of data collected and comfort in treating with thrombolytics.