Clinical Nutrition Unit, ASST G.Pini-CTO, Milan, Italy.
Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Nutrition. 2024 Dec;128:112568. doi: 10.1016/j.nut.2024.112568. Epub 2024 Aug 29.
Parkinsonian syndromes are disabling neurodegenerative diseases resulting in reduced muscle function/performance and sarcopenia, but clinical manifestations could be systemic, including deterioration of cognitive function. As studies have reported an association between muscle dysfunction and cognitive decline yet no information on these syndromes is available, we investigated the relationship between sarcopenia, its components, and cognitive function, fatigue, and quality of life (QoL).
Consecutive patients affected by parkinsonian syndromes were assessed for the presence of sarcopenia using the European Working Group on Sarcopenia in Older People-2 algorithm: low strength (handgrip strength: <27 kg [men]; <16 kg [women]) and low appendicular skeletal muscle index by impedance (<7.0 kg/m [men]; <6.0 kg/m [women]). Cognitive function was evaluated using the Montreal Cognitive Assessment, the Mini Mental State Examination and the Frontal Assessment Battery. Fatigue and QoL were assessed using the 16-item Parkinson's Disease Fatigue Scale and the 39-item Parkinson's Disease Questionnaire, respectively.
In total, 314 patients were included: 198 presented with low strength (63.0% probable sarcopenia); 68 (21.7%) of these were diagnosed with sarcopenia. After adjusting for multiple confounders, we observed a significant effect (poorer score) of both low strength only and sarcopenia on Montreal Cognitive Assessment, Mini Mental State Examination, and QoL. Only reduced muscle strength had a relevant impact on the outcomes considered.
Sarcopenia is associated with worse cognitive functions and QoL in patients with parkinsonian syndromes, with muscle dysfunction playing a major role. The prognostic impact of sarcopenia and its components should be addressed in prospective studies.
帕金森综合征是一种使人丧失活动能力的神经退行性疾病，会导致肌肉功能/表现下降和肌肉减少症，但临床表现可能是全身性的，包括认知功能恶化。由于研究报告称肌肉功能障碍与认知能力下降之间存在关联，但目前尚无关于这些综合征的信息，因此我们研究了肌肉减少症及其组成部分与认知功能、疲劳和生活质量（QoL）之间的关系。
连续评估患有帕金森综合征的患者是否存在肌肉减少症，使用欧洲老年人肌肉减少症工作组-2 算法：低握力（男性：<27 kg；女性：<16 kg）和通过阻抗测量的低四肢骨骼肌指数（男性：<7.0 kg/m；女性：<6.0 kg/m）。使用蒙特利尔认知评估、简易精神状态检查和额叶评估量表评估认知功能。使用帕金森病疲劳量表的 16 项和帕金森病问卷的 39 项分别评估疲劳和 QoL。
共纳入 314 例患者：198 例存在握力降低（63.0%可能存在肌肉减少症）；其中 68 例（21.7%）被诊断为肌肉减少症。在调整了多个混杂因素后，我们观察到仅低握力和肌肉减少症对蒙特利尔认知评估、简易精神状态检查和 QoL 均有显著影响（得分更差）。只有肌肉力量下降对考虑的结果有重要影响。
帕金森综合征患者的肌肉减少症与认知功能和 QoL 下降有关，肌肉功能障碍起主要作用。应在前瞻性研究中探讨肌肉减少症及其组成部分的预后影响。
