Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Geriatrics, Catholic University of Rome, Rome, Italy.
Department of Geriatrics, Foundation Poliambulanza of Brescia, Brescia, Italy.
J Am Med Dir Assoc. 2018 Jun;19(6):523-527. doi: 10.1016/j.jamda.2017.12.005. Epub 2018 Feb 12.
In Parkinson disease (PD), sarcopenia may represent the common downstream pathway that from motor and nonmotor symptoms leads to the progressive loss of resilience, frailty, and disability. Here we (1) assessed the prevalence of sarcopenia in older adults with PD using 3 different criteria, testing their agreement, and (2) evaluated the association between PD severity and sarcopenia.
Cross-sectional, observation study.
Geriatric day hospital.
Older adults with idiopathic PD.
Body composition was evaluated through dual energy x-ray absorptiometry. Handgrip strength and walking speed were measured. Sarcopenia was operationalized according to the Foundation for the National Institutes of Health, the European Working Group on Sarcopenia in Older Persons, and the International Working Group. Cohen k statistics was used to test the agreement among criteria.
Among the 210 participants (mean age 73 years; 38% women), the prevalence of sarcopenia was 28.5%-40.7% in men and 17.5%-32.5% in women. The prevalence of severe sarcopenia was 16.8%-20.0% in men and 11.3%-18.8% in women. The agreement among criteria was poor. The highest agreement was obtained between the European Working Group on Sarcopenia in Older Persons (severe sarcopenia) and International Working Group criteria (k = 0.52 in men; k = 0.65 in women; P < .01 for both). Finally, severe sarcopenia was associated with PD severity (odds ratio 2.30; 95% confidence interval 1.15-4.58).
Sarcopenia is common in PD, with severe sarcopenia being diagnosed in 1 in every 5 patients with PD. We found a significant disagreement among the 3 criteria evaluated, in detecting sarcopenia more than in ruling it out. Finally, sarcopenia is associated with PD severity. Considering its massive prevalence, further studies should address the prognosis of sarcopenia in PD.
在帕金森病（PD）中，肌少症可能代表了一种共同的下游途径，即从运动和非运动症状导致韧性、脆弱和残疾的进行性丧失。在这里，我们（1）使用 3 种不同的标准评估了老年 PD 患者肌少症的患病率，检验了它们的一致性，并（2）评估了 PD 严重程度与肌少症之间的关系。
横断面观察研究。
老年日医院。
特发性 PD 老年患者。
通过双能 X 射线吸收法评估身体成分。测量握力和步行速度。根据美国国立卫生研究院基金会、欧洲老年人肌少症工作组和国际肌少症工作组，肌少症的操作性定义。使用 Cohen k 统计检验标准之间的一致性。
在 210 名参与者中（平均年龄 73 岁；38%为女性），男性肌少症的患病率为 28.5%-40.7%，女性为 17.5%-32.5%。男性严重肌少症的患病率为 16.8%-20.0%，女性为 11.3%-18.8%。标准之间的一致性较差。欧洲老年人肌少症工作组（严重肌少症）和国际肌少症工作组之间的一致性最高（男性 k=0.52；女性 k=0.65；均<0.01）。最后，严重肌少症与 PD 严重程度相关（比值比 2.30；95%置信区间 1.15-4.58）。
肌少症在 PD 中很常见，每 5 名 PD 患者中就有 1 名患有严重肌少症。我们发现，在所评估的 3 种标准中，在检测肌少症方面存在显著差异，而在排除肌少症方面差异较小。最后，肌少症与 PD 严重程度相关。考虑到其广泛的流行程度，应进一步研究肌少症在 PD 中的预后。
