Clinical correlates of sarcopenia and falls in Parkinson’s disease

Abstract

BackgroundSarcopenia is a complex and multifactorial geriatric condition seen in several chronic degenerative diseases. This study aimed to screen for sarcopenia and fall risk in a sample of Parkinson's disease (PD) patients and to investigate demographic and clinical factors associated. MethodsThis is a cross-sectional study. We evaluated 218 PD patients at the Movement Disorders Clinic in Fortaleza, Brazil, and collected clinical data including experiencing falls in the six months prior to their medical visit. Probable sarcopenia diagnosis was confirmed by using a sarcopenia screening tool (SARC-F questionnaire) and the presence of low muscle strength. ResultsOne hundred and twenty-one patients (55.5%) were screened positive for sarcopenia using the SARC-F and 103 (47.4%) met the criteria for probable sarcopenia.Disease duration, modified Hoehn and Yahr stage, Schwab and England Activities of Daily Living Scale score, levodopa equivalent dose, probable sarcopenia and positive SARC-F screening were all associated with experiencing falls. Disease duration, lower quality of life and female gender were independently associated with sarcopenia. Experiencing falls was significantly more frequent among patients screened positive in the SARC-F compared to those screened negative.

Sarcopenia in Patients With Parkinson's Disease: A Systematic Review and Meta-Analysis

“…One study found that higher fat infiltrations were detected in the psoas and thigh muscles in female PD patients compared with female healthy controls (17). Another study found that female sex was independently associated with sarcopenia (16). The current meta-analysis did not find a difference in both male and female sex ratios between PD with and without sarcopenia.…”

“…Another study found that older healthy controls and PD participants had significantly decreased CMC and electromyography (EMG) power at low beta frequencies (13-21 Hz) compared with young healthy controls, whereas there was no difference between the older healthy and PD groups (37). Additionally, one study found that PD participants had significantly decreased beta frequencies (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) for tibialis anterior muscle compared with older healthy controls, whereas there was no difference in the magnitude of CMC between older and younger healthy controls (38). This might hint toward one of the potential features underpinning gait speed changes and risk of falling in PD patients with sarcopenia.…”

“…Among enrolled studies, several studies found no difference in SMMI between PD patients and healthy controls (4,20,21) and among different stages of PD (20); PD patients with sarcopenia had higher UPDRS-III scores (14,15,17), lower fat-free mass index (FFMI) (20), lower ASMMI (14), and lower GS (15) than PD patients without sarcopenia. Moreover, few studies reported that sarcopenia was associated with osteoporosis (16) (17), hyposmia (17), motor physical therapy (16), and social support (16). Therefore, due to the small number of studies, insufficient information of PD patients, and different evaluation standards and statistical methods, some factors, such as GS, HY, depression, LEDD, UPDRS-I, and UPDRS-II, could not be made meta-analysis in this review.…”

“…Four studies (40%) were considered to be at low risk of bias for both study participants and outcome measurement, and one study (10%) (14) was considered to be at high risk of bias for both domains. Two studies (15,16) were considered to be at moderate risk for outcome measurement bias. Seven studies (3,4,17,(19)(20)(21)(22) were considered to be at low risk for outcome measurement bias that used clearly defined diagnostic criteria, reliable and validated instruments, and a similar method and setting of outcome measurement for all participants.…”

“…Several sarcopenia definitions have been developed by different working groups or societies since the first term of sarcopenia was defined in 1988 ( 6 ) [the European Working Group on Sarcopenia in Older People (EWGSOP) ( 7 , 8 ), the International Working Group on Sarcopenia (IWGS) ( 9 ), the Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD) ( 10 ), the Foundation for the National Institutes of Health Biomarkers Consortium Sarcopenia Project (FNIH) ( 11 ), Baumgartner ( 12 ), Newman ( 13 ), the decreased appendicular skeletal muscle mass index (ASMMI) ( 14 ), SARC-F (a tool for screening sarcopenia risk) ( 15 ), probable sarcopenia ( 16 ), early stage sarcopenia (ESS) ( 17 ), and the Asia Working Group for Sarcopenia (AWGS) ( 18 )]. Among which, the most used definition was developed by EWGSOP.…”