Cross-Sectional and Prospective Associations between Parkinsonism and Parkinson's Disease with Frailty in Latin America.

IF 2.6 4区 医学 Q2 CLINICAL NEUROLOGY Movement Disorders Clinical Practice Pub Date : 2024-09-20 DOI:10.1002/mdc3.14214
Dani J Kim, Nusrat Khan, Juan J Llibre-Rodriguez, Miao Jiang, Ana M Rodriguez-Salgado, Isaac Acosta, Ana Luisa Sosa, Daisy Acosta, Ivonne Z Jimenez-Velasquez, Mariella Guerra, Aquiles Salas, Nedelys Díaz Sánchez, Ricardo López-Contreras, Heike Hesse, Caroline Tanner, Jorge J Llibre-Guerra, Matthew Prina
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Abstract

Background: Little is known about the relationship between parkinsonism or Parkinson's disease (PD) and frailty in Latin America.

Objective: The study aimed to determine the cross-sectional and prospective associations between parkinsonism and PD with frailty in a large multi-country cohort in Latin America. Frailty was assessed using three different models to explore which definitions are more appropriate to screen for frailty in a PD population.

Methods: 12,865 older adults (aged ≥65 years) from the 10/66 population-based cohort study in six Latin American countries were analyzed. Logistic regression models assessed the cross-sectional association between parkinsonism/PD with baseline frailty. Individual country analyses were combined via fixed-effect meta-analysis. In non-frail participants who were followed up for 4 years, Cox proportional hazards regression models assessed the prospective association between parkinsonism/PD with incident frailty accounting for competing risk of mortality.

Results: At baseline, the prevalence of parkinsonism and PD was 7% and 2%, respectively, and the prevalence of frailty varied across the three models with rates of 18% for frailty phenotype, 20% for frailty index and 30% for multidimensional frailty model. PD was associated with baseline and incident frailty after accounting for age, sex, and education: odds ratios and 95% confidence intervals (95% CI) for frailty were 2.49 (95% CIs 1.87-3.31), 2.42 (95% CIs 1.80-3.25), and 1.57 (95% CIs 1.16-2.21), and cause-specific hazard ratios were 1.66 (95% CIs 1.07-2.56), 1.78 (95% CIs 1.05-3.03), and 1.58 (95% CIs 0.91-2.74). Similar results were found for parkinsonism.

Conclusion: Parkinsonism and PD were cross-sectionally and prospectively associated with frailty in Latin America. Routine screening for frailty in PD patients may aid earlier detection of those at greater risk of adverse outcomes.

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拉丁美洲帕金森症和帕金森病与虚弱之间的横断面和前瞻性关联。
背景:在拉丁美洲,帕金森病(PD)与虚弱之间的关系鲜为人知:在拉丁美洲,人们对帕金森症或帕金森病(PD)与虚弱之间的关系知之甚少:该研究旨在确定拉丁美洲大型多国队列中帕金森病和帕金森综合症与虚弱之间的横断面和前瞻性关联。采用三种不同的模型对虚弱进行评估,以探讨哪种定义更适合帕金森病人群的虚弱筛查。方法:对拉丁美洲六个国家 10/66 人口队列研究中的 12865 名老年人(年龄≥65 岁)进行了分析。逻辑回归模型评估了帕金森症/帕金森病与基线虚弱之间的横断面关联。通过固定效应荟萃分析对各个国家的分析结果进行了合并。在随访 4 年的非虚弱参与者中,Cox 比例危险回归模型评估了帕金森病/帕金森综合症与事件性虚弱之间的前瞻性关联,并考虑了死亡的竞争风险:基线时,帕金森病和帕金森综合症的患病率分别为 7% 和 2%,而虚弱的患病率在三种模型中各不相同,虚弱表型的患病率为 18%,虚弱指数的患病率为 20%,多维虚弱模型的患病率为 30%。在考虑年龄、性别和教育程度后,PD 与基线和事件性虚弱相关:虚弱的几率比和 95% 置信区间(95% CI)分别为 2.49(95% CI 为 1.87-3.31)、2.42(95% CIs 1.80-3.25)和 1.57(95% CIs 1.16-2.21),病因特异性危险比分别为 1.66(95% CIs 1.07-2.56)、1.78(95% CIs 1.05-3.03)和 1.58(95% CIs 0.91-2.74)。结论:结论:在拉丁美洲,帕金森病和帕金森综合症与虚弱有横截面和前瞻性的关联。对帕金森病患者进行常规体弱筛查有助于及早发现有更大不良后果风险的患者。
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来源期刊
CiteScore
4.00
自引率
7.50%
发文量
218
期刊介绍: Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)
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