Frailty and Parkinson's disease: the role of diabetes mellitus

Klara Komici; Antonella Pansini; Leonardo Bencivenga; Giuseppe Rengo; Gennaro Pagano; Germano Guerra

doi:10.3389/fmed.2024.1377975

Frailty and Parkinson's disease: the role of diabetes mellitus

Front Med (Lausanne). 2024 May 30:11:1377975. doi: 10.3389/fmed.2024.1377975. eCollection 2024.

Authors

Klara Komici¹, Antonella Pansini², Leonardo Bencivenga³, Giuseppe Rengo^{3

4}, Gennaro Pagano^{5

6}, Germano Guerra¹

Affiliations

¹ Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
² ASL Avellino, Avellino, Italy.
³ Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
⁴ Istituti Clinici Scientifici Maugeri IRCCS-Scientific Institute of Telese Terme, Telese Terme, BN, Italy.
⁵ Roche Pharma Research and Early Development (pRED), Neuroscience and Rare Diseases Discovery and Translational Area, Roche Innovation Center, Basel, Switzerland.
⁶ University of Exeter Medical School, London, United Kingdom.

Abstract

Parkinson's disease (PD) is a chronic neurodegenerative disease associated with a progressive loss of dopaminergic neurons, clinically characterized by motor and non-motor signs. Frailty is a clinical condition of increased vulnerability and negative health outcomes due to the loss of multiple physiological reserves. Chronic hyperglycemia and insulin resistance, which characterize diabetes mellitus (DM), have been reported to alter dopaminergic activity, increase the risk of PD, and influence the development of frailty. Even though diabetes may facilitate the development of frailty in patients with PD, this relationship is not established and a revision of the current knowledge is necessary. Furthermore, the synergy between DM, PD, and frailty may drive clinical complexity, worse outcomes, and under-representation of these populations in the research. In this review, we aimed to discuss the role of diabetes in the development of frailty among patients with PD. We summarized the clinical characteristics and outcomes of patients with concomitant DM, PD, and frailty. Finally, interventions to prevent frailty in this population are discussed.

Keywords: Parkinson’s disease; aging; diabetes mellitus; frailty; hyperglycemia; insulin resistance.

Publication types

Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This project was supported with funding from Next Generation EU, in the context of the National Recovery and Resilience Plan, Investment PE8–Project Age-It: “Ageing Well in an Ageing Society.” This resource was co-financed by Next Generation EU [DM 1557 11.10.2022]. The views and opinions expressed are only those of the authors and do not necessarily reflect those of the European Union or the European Commission. Neither the European Union nor the European Commission can be held responsible for them. This research has also received funding in part from Project “A wearable sysTem for moTion and glucosE joiNT monItOriNg for neurodegenerative disease status evaluation in elder people”, CUP MASTER D53D23015960001, CUP H53D23007310001 funded by EU in NextGenerationEU plan through the Italian “Bando Prin 2022 PNRR - D.D. 1409 del 14-09-2022” by MUR.