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The role of frailty in Parkinson’s disease: a cross-sectional study

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Abstract

Background

Frailty is an age-related state of increased risk for health-related adverse outcomes that reflects multisystem physiological changes and likely influences the clinical expression and disease progression of neurodegenerative disorders. The aim of the present study was to assess the potential relationship between frailty, as assessed by a frailty index (FI), and motor symptom severity, motor subtypes, and non-motor domains in Parkinson’s disease (PD).

Methods

We consecutively enrolled 150 PD patients. We administered an FI specifically designed for PD that included 50 age-related multidimensional biological deficits. Patients underwent a clinical assessment that evaluated motor and non-motor manifestations of PD. Using the FI score, we classified PD patients as relatively fit (FI ≤ 0.10), less fit (0.10 < FI ≤ 0.21), or frail (FI > 0.21). A linear regression model was designed to explore possible associations between frailty level and PD motor and non-motor manifestations.

Results

Frail patients showed greater motor symptom severity and motor complications than fitter patients. A trend towards a higher prevalence of the postural instability/gait disorder subtype was also observed in frail versus relatively fit and less fit patients. The global burden of non-motor symptoms was higher in frail patients. Increased frailty was associated with more severe motor and non-motor symptoms, as well as with more pronounced cognitive deficits. These associations remained significant even when “traditional” predictors of PD severity (age, disease duration, and levodopa equivalent daily dose) were considered.

Conclusions

The present findings indicate that the FI is associated with both motor and non-motor features of PD.

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Acknowledgements

We thank Melissa Kerr for the language editing.

Funding

Nothing to declare.

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Author notes

  1. Daniele Belvisi and Marco Canevelli contributed equally to this work.

Authors and Affiliations

  1. Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, 00185, Rome, Italy

    Daniele Belvisi, Marco Canevelli, Matteo Costanzo, Margherita Giangrosso, Andrea Fabbrini, Andrea Borraccino, Giuseppe Bruno, Alfredo Berardelli & Giovanni Fabbrini

  2. IRCCS Neuromed, via Atinense 18, 86077, Pozzilli, IS, Italy

    Daniele Belvisi, Alfredo Berardelli & Giovanni Fabbrini

  3. National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy

    Marco Canevelli

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  1. Daniele Belvisi
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Correspondence to Giovanni Fabbrini.

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The research documented in this manuscript has been carried out in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Belvisi, D., Canevelli, M., Costanzo, M. et al. The role of frailty in Parkinson’s disease: a cross-sectional study. J Neurol 269, 3006–3014 (2022). https://doi.org/10.1007/s00415-021-10873-3

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  • DOI: https://doi.org/10.1007/s00415-021-10873-3

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