Smith Natalie, Gaunt Daisy M, Whone Alan, Ben-Shlomo Yoav, Henderson Emily J
Royal United Hospitals Bath NHS Trust, Bath, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Can Geriatr J. 2021 Mar 2;24(1):22-25. doi: 10.5770/cgj.24.437. eCollection 2021 Mar.
Frailty and Parkinson's disease (PD) are both highly prevalent in older people, but few studies have studied frailty in people with Parkinson's. Identifying frailty in this population is vital, to target new interventions to those who would most benefit.
Data were collected as part of the double-blind randomised controlled rivastigmine to stabilise gait ReSPonD trial in 130 people with Hoehn and Yahr 2-3, idiopathic PD who had fallen in the year prior to enrolment. Individuals were assessed at baseline and followed up at eight months, including determination of frailty status.
120 patients attended for follow-up. At follow-up, the mean (SD) age was 70.2 years (8.0), MDS-UPDRS total score 91.5 (29.1), and MDS-UPDRS motor score (Part III) 42.7 (14.8). Median disease duration was 9.2 years (IQR 4.6 to 13.1), Geriatric Depression Score 4 (IQR 2 to 6). Using the Fried frailty criteria, 31 (26%) were frail and 70 (58%) pre-frail. In univariable analysis, being female, higher depression score, and MDS-UPDRS score were associated with greater frailty. Using ordinal regression, in the multivariable model, being female (odds ratio [OR] 3.10, 95%CI 1.53 to 6.26, =.002), higher total MDS-UPDRS score (OR 2.02, 95%CI 1.42 to 2.87, <.0001) and higher depression (OR 1.47, 95%CI 1.05 to 2.06, =.03) were associated with higher number of frailty markers.
There was a high prevalence (84%) of pre-frail and frail individuals in patients participating in this RCT. Future research should determine the optimum tool to assess frailty in this at-risk population, and delineate the association between Parkinson's, frailty, and health outcomes.
衰弱和帕金森病（PD）在老年人中都非常普遍，但很少有研究对帕金森病患者的衰弱情况进行研究。识别该人群中的衰弱至关重要，以便针对最能从中受益的人群采取新的干预措施。
数据收集自一项双盲随机对照试验，该试验使用卡巴拉汀来稳定步态，即ReSPonD试验，研究对象为130名Hoehn - Yahr分级为2 - 3级的特发性帕金森病患者，这些患者在入组前一年曾有过跌倒经历。个体在基线时接受评估，并在八个月时进行随访，包括确定衰弱状态。
120名患者参加了随访。随访时，平均（标准差）年龄为70.2岁（8.0），MDS - UPDRS总分91.5（29.1），MDS - UPDRS运动评分（第三部分）42.7（14.8）。疾病中位持续时间为9.2年（四分位间距4.6至13.1），老年抑郁量表评分为4（四分位间距2至6）。使用弗里德衰弱标准，31人（26%）为衰弱，70人（58%）为衰弱前期。在单变量分析中，女性、更高的抑郁评分和MDS - UPDRS评分与更高的衰弱程度相关。使用有序回归分析，在多变量模型中，女性（优势比[OR] 3.10，95%置信区间1.53至6.26，P = 0.002）、更高的MDS - UPDRS总分（OR 2.02，95%置信区间1.42至2.87，P < 0.0001）和更高的抑郁程度（OR 1.47，95%置信区间1.05至2.06，P = 0.03）与更多的衰弱标志物相关。
参与该随机对照试验的患者中，衰弱前期和衰弱个体的患病率很高（84%）。未来的研究应确定评估该高危人群衰弱情况的最佳工具，并阐明帕金森病、衰弱与健康结局之间的关联。
