Chatkaew Pongmala, Ph.D., Functional Neuroimaging, Cognitive and Mobility Laboratory, Department of Radiology, University of Michigan, 24 Frank Lloyd Wright Drive, Box 362, Ann Arbor, MI 48105-9755, USA. TEL: (1) 734 998 8400. E-mail:
J Frailty Aging. 2024;13(3):293-299. doi: 10.14283/jfa.2024.31.
Postural instability and gait difficulties (PIGD) are a significant cause of mobility loss and lower quality of life in Parkinson's disease (PD). When PD progresses, patients may experience falls and freezing of gait (FoG) resulting in fear of falling and increasing sedentariness. Sedentary behavior results in sarcopenia associated with other changes in body composition, especially in older patients becoming frail. Previous studies have shown gender-specific changes in body composition with aging as well as gender disparities in symptoms and progression of PD, yet the association between gender-specific body composition and PIGD symptoms such as FoG along with falls, remains unexplored.
This study aimed to investigate the association between gender-specific changes in body composition, FoG and falls assessment.
136 PD subjects underwent detailed clinical test batteries and had whole-body composition assessed using dual-energy X-ray absorptiometry (DXA). Multivariate logistic forward stepwise regression was performed to define body composition associations for FoG and falls.
Multivariate regression analysis revealed that in males with PD, lower leg lean mass was significantly associated with the presence of FoG (OR, 0.429; 95% CI, 0.219-0.839; p=0.013) but not with falls. In females with PD, higher leg adipose mass was significantly associated with falls (OR, 4.780; 95% CI, 1.506-15.174; p=0.008) but not with FoG.
These observations suggest gender specific associations between body composition and FoG vs. falls in PD. Future research should explore the impact of interventions on body composition in individuals with PD by paying specific attention to gender differences.
姿势不稳和步态困难（PIGD）是帕金森病（PD）导致运动能力丧失和生活质量下降的重要原因。随着 PD 的进展，患者可能会出现跌倒和步态冻结（FoG），从而导致跌倒恐惧和活动减少。久坐行为会导致与身体成分其他变化相关的肌肉减少症，尤其是在年老体弱的患者中。先前的研究表明，身体成分会随着年龄的增长而发生性别特异性变化，以及 PD 症状和进展方面的性别差异，但性别特异性身体成分与 FoG 以及跌倒等 PIGD 症状之间的关联仍未得到探索。
本研究旨在探讨性别特异性身体成分变化与 FoG 和跌倒评估之间的关系。
136 名 PD 患者接受了详细的临床测试，并使用双能 X 射线吸收法（DXA）进行了全身成分评估。采用多元逻辑向前逐步回归分析定义了 FoG 和跌倒的身体成分相关性。
多元回归分析显示，在 PD 男性中，小腿瘦体重与 FoG 的存在显著相关（OR，0.429；95%CI，0.219-0.839；p=0.013），但与跌倒无关。在 PD 女性中，腿部脂肪量与跌倒显著相关（OR，4.780；95%CI，1.506-15.174；p=0.008），但与 FoG 无关。
这些观察结果表明，PD 中身体成分与 FoG 与跌倒之间存在性别特异性关联。未来的研究应通过特别关注性别差异，探索针对 PD 患者的身体成分干预措施的影响。
