Frailty and Prodromal Parkinson's Disease: Results From the HELIAD Study

Eva Ntanasi; Maria Maraki; Mary Yannakoulia; Maria Stamelou; Georgia Xiromerisiou; Mary H Kosmidis; Efthimios Dardiotis; Georgios Hadjigeorgiou; Paraskevi Sakka; Antonios Gargalionis; Kostas Patas; Stylianos Chatzipanagiotou; Socrates Charisis; Leonidas Stefanis; Nikolaos Scarmeas

doi:10.1093/gerona/glaa191

Frailty and Prodromal Parkinson's Disease: Results From the HELIAD Study

J Gerontol A Biol Sci Med Sci. 2021 Mar 31;76(4):622-629. doi: 10.1093/gerona/glaa191.

Authors

Eva Ntanasi^{1

2}, Maria Maraki^{1

3}, Mary Yannakoulia¹, Maria Stamelou^{4

5}, Georgia Xiromerisiou⁶, Mary H Kosmidis⁷, Efthimios Dardiotis⁶, Georgios Hadjigeorgiou⁸, Paraskevi Sakka⁹, Antonios Gargalionis¹⁰, Kostas Patas¹⁰, Stylianos Chatzipanagiotou¹⁰, Socrates Charisis², Leonidas Stefanis^{2

11}, Nikolaos Scarmeas^{2

12}

Affiliations

¹ Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
² 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece.
³ Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Greece.
⁴ Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece.
⁵ Department of Neurology, Philipps University, Marburg, Germany.
⁶ School of Medicine, University of Thessaly, Larissa, Greece.
⁷ Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece.
⁸ Department of Neurology, Medical School, University of Cyprus, Nicosia.
⁹ Athens Association of Alzheimer's Disease and Related Disorders, Greece.
¹⁰ Department of Medical Biopathology and Clinical Microbiology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece.
¹¹ Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Greece.
¹² Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York.

PMID: 32761172
DOI: 10.1093/gerona/glaa191

Abstract

Background: To investigate the association between frailty, Parkinson's disease (PD), and the probability of prodromal Parkinson's disease (prodromal PD) in Greek community-dwelling older individuals.

Methods: Parkinson's disease diagnosis was reached through standard clinical research procedures. Probability of prodromal PD was calculated according to the International Parkinson and Movement Disorder Society's research criteria for PD-free participants. Frailty was evaluated according to definitions of the phenotypic and multidomain approach. Logistic and linear regression models were performed to investigate associations between frailty (predictor) and the probability of prodromal PD, either continuous or dichotomous (≥30% probability score), or PD (outcome).

Results: Data from 1765 participants aged 65 and older were included in the present analysis. Parkinson's disease and prodromal PD prevalence were 1.9% and 3.0%, respectively. Compared to nonfrail participants, those who were frail, as identified with either the Fried frailty phenotype or Frailty Index had approximately 4 (odds ratio [OR] 4.09, 95% confidence interval [CI] 1.54-10.89) and 12 times (OR 12.16, 95% CI 5.46-27.09) higher odds of having a PD diagnosis, respectively. Moreover, compared to the nonfrail, frail participants as identified with either the Fried frailty phenotype or Frailty Index had 2.8 (OR 2.83, 95% CI 1.09-7.37) and 8.3 times (OR 8.39, 95% CI 4.56-15.42) higher odds of having possible/probable prodromal PD, respectively.

Conclusions: Frailty status was associated with prodromal PD and PD, suggesting common characteristics or underlying mechanisms of these conditions. Although prospective studies are warranted, acknowledging the possible association of frailty, PD, and prodromal PD may improve their clinical management.

Keywords: Aging; Movement disorders; Neurological disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aging* / physiology
Aging* / psychology
Female
Frailty* / diagnosis
Frailty* / epidemiology
Geriatric Assessment* / methods
Geriatric Assessment* / statistics & numerical data
Greece / epidemiology
Humans
Independent Living / statistics & numerical data
Male
Neurologic Examination / methods
Neuropsychological Tests
Parkinson Disease* / diagnosis
Parkinson Disease* / epidemiology
Parkinson Disease* / physiopathology
Parkinson Disease* / psychology
Prevalence
Prodromal Symptoms*
Risk Assessment
Risk Factors
Severity of Illness Index
Symptom Assessment