Dissertation committee:
Εμμανουήλ Βελονάκης, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Δημήτριος Αναστασόπουλος, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Φωτεινή Στυλιανοπούλου, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Παναγιώτα Σουρτζή, Αν. Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Μαριάννα Διομήδους, Επ. Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Ιωάννης Ελευσινιώτης, Επ. Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Αντώνιος Σταματάκης, Επ. Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Background: Parkinson’s Disease is a multifactor, degenerative disease of the central nervous system and belongs to the εξωπυραμιδικές συνδρομές. The prevalence of Parkinson’s Disease varies from place to place and because of age, but WHO refers that there are 200 cases per 100.000 population globally and is one of the most severe diseases of the central nervous system. Environmental factors and genetic factors play a significant role on the manifestation of Parkinson’s Disease.
Aim of the study: With this study there was an effort to identify and record the most important factors for Parkinson’s Disease in Greece.
Methods: From November 2009 to April 2011 a prospective case-control study was conducted. In the sample were included 120 patients who visited the Movement Disorder Clinic of the General Hospital of Athens “Georgios Gennimatas” and also patients who visited Kalivia Health Centre and 153 controls from the two orthopedic clinics of the hospital and also from the ER of the Health Centre. A structured questionnaire was developed, based on the results of international epidemiological studies on Parkinson’s Disease. The data collection was done with the completion of the questionnaire, by means of an interview of patients and controls. The questionnaire included information about the demographic characteristics, the family history for Parkinson’s Disease and other neurological diseases, the dietary habits, smoking, exercise, the consumption of well-water, the exposure to pesticides and occupational exposure to metals. The data of the questionnaires were analysed with the statistic programme STATA IC 10.
Results: A total of 120 diagnosed patients and 153 controls were included in the study. The disease is more frequent among men than women, as the results showed. According to the results of the univariate analysis, the factors that had a statistically significant correlation with the disease frequency (p-value <0,01) were the age, the exposure to pesticides, the duration of the pesticide’s exposure, the spraying with pesticides, the war sports, as karate, the family history for Parkinson’s Disease and smoking. The multivariate logistic regression included all the variables that had p<0,10 in the univariate analysis. Two multivariate models were created, model I included the possible risk and the “protective” factors and Model II only the possible risk factors. According to the results of the multivariate analysis, the exposure to pesticides increase the risk to both models (model Ι OR=2,95 (95% CI: 1,53-5,69 και model ΙΙ ΟR=2,61 (1,33- 5,11), the duration of the exposure to pesticides increased also the risk (model I OR=1,03 (95% CI: 1,00-1,05 and model II OR=1,02 (95% CI: 1,00-1,05). The spraying of pesticides increases also the risk (ΟR=1,8 (95%CI:0,95-3,41) in model Ι and in model II ΟR=1,53 (95% CI: 0,79-2,96). The relative risk in patients you had previously stroke was bigger (model Ι OR= 3,66 (95% CI: 0,89- 15,4) and model ΙΙ OR=4,31 (95%CI: 0,95-19,44). The patients who had smoked more than 600 cigarettes had smaller risk for Parkinson’s Disease in both two model (model Ι OR=0,26 (95%CI: 0,07-0,98) and model ΙΙ OR=0,19 (95%CI: 0,04-0,9). The history of falls and head injures seems to ptotect from the disease, in contrast of the bibliography.
Conclusions: Even though there is a need for further studies about the risk factors who relate with Parkinson’s Disease, the adoption of the appropriate preventive strategies aiming at the recognized risk factors can contribute to the reduction of the disease. The exposure to pesticides, the duration of the exposure, the spraying of pesticides seems to increase the risk for Parkinson’s Disease, so there is the necessity of a preventing program which emphasizes to individual measurements of protection. The Parkinson’s Disease after a stroke indicate the necessity for a better diet and exercising, in order to prevent it and consequently Parkinson’s Disease.
