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Komici K, Pansini A, Bencivenga L, Rengo G, Pagano G, Guerra G. Frailty and Parkinson's disease: the role of diabetes mellitus. Front Med (Lausanne) 2024; 11:1377975. [PMID: 38882667 PMCID: PMC11177766 DOI: 10.3389/fmed.2024.1377975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 05/02/2024] [Indexed: 06/18/2024] Open
Abstract
Parkinson's disease (PD) is a chronic neurodegenerative disease associated with a progressive loss of dopaminergic neurons, clinically characterized by motor and non-motor signs. Frailty is a clinical condition of increased vulnerability and negative health outcomes due to the loss of multiple physiological reserves. Chronic hyperglycemia and insulin resistance, which characterize diabetes mellitus (DM), have been reported to alter dopaminergic activity, increase the risk of PD, and influence the development of frailty. Even though diabetes may facilitate the development of frailty in patients with PD, this relationship is not established and a revision of the current knowledge is necessary. Furthermore, the synergy between DM, PD, and frailty may drive clinical complexity, worse outcomes, and under-representation of these populations in the research. In this review, we aimed to discuss the role of diabetes in the development of frailty among patients with PD. We summarized the clinical characteristics and outcomes of patients with concomitant DM, PD, and frailty. Finally, interventions to prevent frailty in this population are discussed.
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Affiliation(s)
- Klara Komici
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | | | - Leonardo Bencivenga
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
- Istituti Clinici Scientifici Maugeri IRCCS-Scientific Institute of Telese Terme, Telese Terme, BN, Italy
| | - Gennaro Pagano
- Roche Pharma Research and Early Development (pRED), Neuroscience and Rare Diseases Discovery and Translational Area, Roche Innovation Center, Basel, Switzerland
- University of Exeter Medical School, London, United Kingdom
| | - Germano Guerra
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
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Hähnel T, Raschka T, Sapienza S, Klucken J, Glaab E, Corvol JC, Falkenburger BH, Fröhlich H. Progression subtypes in Parkinson's disease identified by a data-driven multi cohort analysis. NPJ Parkinsons Dis 2024; 10:95. [PMID: 38698004 PMCID: PMC11066039 DOI: 10.1038/s41531-024-00712-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/16/2024] [Indexed: 05/05/2024] Open
Abstract
The progression of Parkinson's disease (PD) is heterogeneous across patients, affecting counseling and inflating the number of patients needed to test potential neuroprotective treatments. Moreover, disease subtypes might require different therapies. This work uses a data-driven approach to investigate how observed heterogeneity in PD can be explained by the existence of distinct PD progression subtypes. To derive stable PD progression subtypes in an unbiased manner, we analyzed multimodal longitudinal data from three large PD cohorts and performed extensive cross-cohort validation. A latent time joint mixed-effects model (LTJMM) was used to align patients on a common disease timescale. Progression subtypes were identified by variational deep embedding with recurrence (VaDER). In each cohort, we identified a fast-progressing and a slow-progressing subtype, reflected by different patterns of motor and non-motor symptoms progression, survival rates, treatment response, features extracted from DaTSCAN imaging and digital gait assessments, education, and Alzheimer's disease pathology. Progression subtypes could be predicted with ROC-AUC up to 0.79 for individual patients when a one-year observation period was used for model training. Simulations demonstrated that enriching clinical trials with fast-progressing patients based on these predictions can reduce the required cohort size by 43%. Our results show that heterogeneity in PD can be explained by two distinct subtypes of PD progression that are stable across cohorts. These subtypes align with the brain-first vs. body-first concept, which potentially provides a biological explanation for subtype differences. Our predictive models will enable clinical trials with significantly lower sample sizes by enriching fast-progressing patients.
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Affiliation(s)
- Tom Hähnel
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany.
- Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
| | - Tamara Raschka
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, University of Bonn, Bonn, Germany
| | - Stefano Sapienza
- Biomedical Data Science, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Jochen Klucken
- Biomedical Data Science, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Luxembourg Institute of Health (LIH), Strassen, Luxembourg
- Centre Hospitalier de Luxembourg (CHL), Strassen, Luxembourg
| | - Enrico Glaab
- Biomedical Data Science, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Jean-Christophe Corvol
- Sorbonne Université, Paris Brain Institute - ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Neurology, Paris, France
| | - Björn H Falkenburger
- Department of Neurology, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Holger Fröhlich
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, University of Bonn, Bonn, Germany
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Dallaire M, Houde-Thibeault A, Bouchard-Tremblay J, Wotto EA, Côté S, Santos Oliveira C, Ngomo S, da Silva RA. Impact of frailty and sex-related differences on postural control and gait in older adults with Parkinson's Disease. Exp Gerontol 2024; 186:112360. [PMID: 38215954 DOI: 10.1016/j.exger.2024.112360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/18/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Parkinson's Disease (PD), a neurodegenerative condition, affects normal aging and leads to reduced motor abilities. In addition, frailty syndrome can increase vulnerability and risks of undesirable effects such as disease progression, falls, disability, and premature death among individuals with PD. AIMS To assess the impact of frailty on balance and gait parameters in older with PD and to determine if sex mediates these measures. METHODS Twenty-seven (27) participants (n = 18 men; n = 10 frail) performed 4 balance tasks on a force platform (eyes opened/closed in bipodal/semi-tandem position) while linear center of pressure (COP) parameters were calculated. Participants also performed two different speed walks on a gait analysis system to assess gait parameters. RESULTS Significant differences between the frail and non-frail group were observed on postural control (mainly for area of COP p = 0.013/d = 0.47/70 %; sway velocity p = 0.048/d = 0.41/23 %) where frail reported poor balance. No significant sex differences were reported for postural control. Gait analysis was comparable between frail and non-frail, while significant differences between men and women were observed for step length (p = 0.002, d = 0.71), step width (p = 0.001, d = 0.75) and base of support (p = 0.012, d = 0.64) variables. CONCLUSION Frail Parkinson's individuals present poorer postural control than non-frail individuals, but comparable gait parameters. Men and women are comparable on postural control but show different gait parameters. These results may have implications in clinical decision-making in rehabilitation for frailty in older adults, men and women with Parkinson's disease when balance and gait are of concern.
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Affiliation(s)
- Mathieu Dallaire
- Programme de maîtrise en sciences cliniques et biomédicales, Département des Sciences de la Santé de l'Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada; Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Alexandra Houde-Thibeault
- Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Jérôme Bouchard-Tremblay
- Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Enafa Anais Wotto
- Programme de maîtrise en sciences cliniques et biomédicales, Département des Sciences de la Santé de l'Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada; Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Sharlène Côté
- Centre intégré de santé et services sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Services at La Baie Hospital, Saguenay, Quebec G7H 7K9, Canada
| | - Claudia Santos Oliveira
- Human Movement and Rehabilitation, Universidade Evangélica de Goiás, Anapolis 75083-515, Brazil
| | - Suzy Ngomo
- Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada; Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada
| | - Rubens A da Silva
- Laboratoire de recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada; Centre intégré de santé et services sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Services at La Baie Hospital, Saguenay, Quebec G7H 7K9, Canada; Human Movement and Rehabilitation, Universidade Evangélica de Goiás, Anapolis 75083-515, Brazil; Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Quebec G7H 2B1, Canada.
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Zhang Z, Liu N, Pan X, Zhang C, Yang Y, Li X, Shao Y. Assessing causal associations between neurodegenerative diseases and neurological tumors with biological aging: a bidirectional Mendelian randomization study. Front Neurosci 2023; 17:1321246. [PMID: 38169680 PMCID: PMC10758410 DOI: 10.3389/fnins.2023.1321246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
Background Aging is a significant risk factor for many neurodegenerative diseases and neurological tumors. Previous studies indicate that the frailty index, facial aging, telomere length (TL), and epigenetic aging clock acceleration are commonly used biological aging proxy indicators. This study aims to comprehensively explore potential relationships between biological aging and neurodegenerative diseases and neurological tumors by integrating various biological aging proxy indicators, employing Mendelian randomization (MR) analysis. Methods Two-sample bidirectional MR analyses were conducted using genome-wide association study (GWAS) data. Summary statistics for various neurodegenerative diseases and neurological tumors, along with biological aging proxy indicators, were obtained from extensive meta-analyses of GWAS. Genetic single-nucleotide polymorphisms (SNPs) associated with the exposures were used as instrumental variables, assessing causal relationships between three neurodegenerative diseases (Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis), two benign neurological tumors (vestibular schwannoma and meningioma), one malignant neurological tumor (glioma), and four biological aging indicators (frailty index, facial aging, TL, and epigenetic aging clock acceleration). Sensitivity analyses were also performed. Results Our analysis revealed that genetically predicted longer TL reduces the risk of Alzheimer's disease but increases the risk of vestibular schwannoma and glioma (All Glioma, GBM, non-GBM). In addition, there is a suggestive causal relationship between some diseases (PD and GBM) and DNA methylation GrimAge acceleration. Causal relationships between biological aging proxy indicators and other neurodegenerative diseases and neurological tumors were not observed. Conclusion Building upon prior investigations into the causal relationships between telomeres and neurodegenerative diseases and neurological tumors, our study validates these findings using larger GWAS data and demonstrates, for the first time, that Parkinson's disease and GBM may promote epigenetic age acceleration. Our research provides new insights and evidence into the causal relationships between biological aging and the risk of neurodegenerative diseases and neurological tumors.
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Affiliation(s)
- Zhiyun Zhang
- Department of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun, China
| | - Ningfang Liu
- Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xuyang Pan
- Department of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun, China
| | - Chuyi Zhang
- Department of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun, China
| | - Yifan Yang
- The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Xinyun Li
- Infection Department, The First Bethune Hospital of Jilin University, Changchun, China
| | - Ying Shao
- Department of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun, China
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Zheng Z, Lv Y, Rong S, Sun T, Chen L. Physical Frailty, Genetic Predisposition, and Incident Parkinson Disease. JAMA Neurol 2023; 80:455-461. [PMID: 36912851 PMCID: PMC10012040 DOI: 10.1001/jamaneurol.2023.0183] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Importance Cross-sectional evidence implicates high prevalent frailty in patients with Parkinson disease (PD), whereas the longitudinal association remains unknown. Objectives To examine the longitudinal association of the frailty phenotype with the development of PD and to explore the modification role of genetic risk of PD in such an association. Design, Setting, and Participants This prospective cohort study launched in 2006 to 2010 with a follow-up of 12 years. Data were analyzed from March 2022 to December 2022. The UK Biobank recruited over 500 000 middle-aged and older adults from 22 assessment centers across the United Kingdom. Participants who were younger than 40 years (n = 101), diagnosed with dementia or PD at baseline, and developed dementia, PD, or died within 2 years from baseline were excluded (n = 4050). Participants who had no genetic data or mismatch between genetic sex and reported gender (n = 15 350), were not of self-reported British White descent (n = 27 850), and had no data for frailty assessment (n = 100 450) or any covariates were also excluded (n = 39 706). The final analysis included 314 998 participants. Exposures The physical frailty was assessed by the Fried criteria's frailty phenotype through 5 domains, ie, weight loss, exhaustion, low physical activity, slow walking speed, and low grip strength. The polygenic risk score (PRS) for PD comprised 44 single-nucleotide variants. Main Outcomes and Measures New-onset PD was identified through the hospital admission electronic health records and death register. Results Among 314 998 participants (mean age, 56.1 years; 49.1% male), 1916 new-onset PD cases were documented. Compared with nonfrailty, the hazard ratio (HR) of incident PD in prefrailty and frailty was 1.26 (95% CI, 1.15-1.39) and 1.87 (95% CI, 1.53-2.28), respectively, and the absolute rate difference per 100 000 person-years was 1.6 (95% CI, 1.0-2.3) for prefrailty and 5.1 (95% CI, 2.9-7.3) for frailty. Exhaustion (HR, 1.41; 95% CI, 1.22-1.62), slow gait speed (HR, 1.32; 95% CI, 1.13-1.54), low grip strength (HR, 1.27; 95% CI, 1.13-1.43), and low physical activity (HR, 1.12; 95% CI, 1.00-1.25) were associated with incident PD. A significant interaction between frailty and PRS on PD was found and the highest hazard was observed in participants with frailty and high genetic risk. Conclusions and Relevance Physical prefrailty and frailty were associated with incident PD independent of sociodemographic factors, lifestyles, multiple morbidities, and genetic background. These findings may have implications for the assessment and management of frailty for PD prevention.
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Affiliation(s)
- Zekun Zheng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanling Lv
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Taoping Sun
- Zhuhai Precision Medicine Center, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai, Guangdong, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Baione V, Canevelli M, Belvisi D, Buscarinu MC, Bellucci G, Fantozzi R, Nicoletti CG, Malatuni G, Cortese A, De Giglio L, Tartaglia M, Ferrazzano G, Malimpensa L, Leodori G, Bruno G, Ferraro E, Marfia GA, Centonze D, Salvetti M, Conte A. Frailty and relapse activity in multiple sclerosis: A longitudinal observation. Mult Scler Relat Disord 2023; 72:104603. [PMID: 36905818 DOI: 10.1016/j.msard.2023.104603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/17/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
Recent cross-sectional investigations suggest a relationship between frailty, as measured by Frailty Index (FI), and multiple sclerosis (MS). However, if and how frailty is associated with relapse activity in MS is still unknown. To explore this issue, a one-year follow-up study involving 471 patients was conducted. A univariate regression model showed an inverse association between baseline FI score and the presence of relapse, which was also confirmed in the multivariate model. These results suggest that frailty may reflect pathophysiological mechanisms involved in MS disease activity and that the FI may be used as an enrichment criterion in clinical trials.
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Affiliation(s)
- Viola Baione
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Marco Canevelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - Maria Chiara Buscarinu
- Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza, University of Rome, Rome, Italy
| | - Gianmarco Bellucci
- Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza, University of Rome, Rome, Italy
| | | | - Carolina Gabri Nicoletti
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Giorgia Malatuni
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | | | - Matteo Tartaglia
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy
| | - Giuseppe Bruno
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Girolama Alessandra Marfia
- IRCCS Neuromed, Pozzilli, IS, Italy; Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Diego Centonze
- IRCCS Neuromed, Pozzilli, IS, Italy; Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Marco Salvetti
- IRCCS Neuromed, Pozzilli, IS, Italy; Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza, University of Rome, Rome, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, IS, Italy.
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Sousa-Fraguas MC, Rodríguez-Fuentes G, Conejo NM. Frailty and cognitive impairment in Parkinson’s disease: a systematic review. Neurol Sci 2022; 43:6693-6706. [PMID: 36056182 DOI: 10.1007/s10072-022-06347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/12/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Frailty can lead to increased vulnerability in older people and patients with Parkinson's disease (pwPD) and worsen their health conditions. These patients can also develop cognitive function impairment. The objective is to analyze whether there is a relationship between frailty and cognitive impairment in pwPD, and to find out which instruments to use for its evaluation. METHODS Publications were searched in PubMed, Medline, Web of Science, Cinalh, Cochrane Library, Embase, Phycinfo, and Scopus. The results were measured with the instruments that are used to assess frailty and cognitive impairment, and analyze their relationship. RESULTS Two hundred seventy-one articles were identified, of which 12 met the inclusion criteria. All studies assessed frailty and cognitive function in pwPD. Five studies analyzed the relationship between frailty and cognitive impairment. The most used instruments were the Fried scale followed by the Clinical Frailty Scale (CFS) for frailty. Cognitive impairment was mostly evaluated with the Mini-Mental State Examination and the Montreal Cognitive Assessment. The prevalence data ranged from 20.2 to 51.5% with the Fried scale and from 35.6 to 83.9% with the CFS. Cognitive impairment was present in 15 to 45.2% of the pwPD. CONCLUSION Analysis of the included studies shows a relationship between frailty and cognitive impairment in pwPD. There was significant variability in the application of the scales used, which influences the prevalence data. More observational and experimental studies are needed to provide more evidence on this association and to determine which is the optimal tool to identify frailty in pwPD using multidimensional scales.
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Xie D, Huang H, Zhao Q, Ning P, Shen Q, Lu H, Xu F, Fu X, Xu Y. Prevalence and associated factors of frailty and sarcopenia in multiple system atrophy and progressive supranuclear palsy: a cross-sectional study. Neurol Sci 2022; 43:6329-6337. [DOI: 10.1007/s10072-022-06296-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/22/2022] [Indexed: 12/11/2022]
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