Função pulmonar e qualidade de vida de idosos com doença de Parkinson em estágios iniciais: estudo transversal

Abstract

Introduction: Parkinson's disease (PD) is the second most prevalent neurodegenerative disease in the world. It is a chronic and progressive disease of the central nervous system that occurs more often with the elderly (2-3%). It is characterized by neuromotor symptoms. However, respiratory dysfunctions demonstrate high morbidity/mortality. The objective of this study was to evaluate the respiratory function of elderly patients with PD in the early stages analyzing the prevalence of ventilatory disorders, respiratory muscle strength and quality of life (QoL) and to compare these results with that of elderly without PD. Method: A cross-sectional study with a sample of 41 elderly patients with PD (Parkinson Group PG) and convenience sample of 41 elderly without PD (Control Group CG). The PG was evaluated for the degree of disease dysfunction (modified Hoehn & Yahr scale), just including people with 1-3 degree. In both groups QoL (WHOQOL-bref) and respiratory function (spirometry and manovacuometry) were evaluated. Data were analyzed with measures of central tendency and variation and previously submitted to the Shapiro-Wilk normality test. For qualitative variables was used the Fischer's exact test; For the comparison between the groups was used Student's T test and Mann Whitney test. For the correlations, the linear regression model was used. To compare the variables of interest the ANOVA and Kruskal-Wallis tests were used, with the statistical software R 3.3.0. The level of significance was 5%. Results: The presence of ventilatory disorders was greater in PG than in CG (p <0.001), with restrictive disorder being the most prevalent. Obstructive disorder was observed only in PG. The values of the maximum respiratory pressures were within the range of normality and without difference with the controls. However, they were significantly lower at levels 2 and 3 of the HY scale (p = 0.007 and p = 0.004, respectively). Pimáx had a direct association with FVC in PG (p = 0.038 and R2 = 0.125), which was only observed in CG with restrictive disorder. The perception of QoL was low in both groups, being lower in PG. The worst scores were in the general domain (p = 0.005) and in the psychological (p = 0.003), physical (p = 0.003) and social relations (p = 0.015) domains. Conclusion: In the elderly with PD, even in the early stages of the disease, there was a higher prevalence of ventilatory disorders than its controls, with the restrictive disorder being the most prevalent. Respiratory muscle strength was normal in these individuals. The perception of QoL was low in the elderly evaluated, but lower in the PG.