Frailty Common in Patients With Parkinson Disease

Approximately 38% of patients with Parkinson disease also qualify as frail per the frailty phenotype screening measure, according to a systematic review and meta-analysis published online in Clinical Parkinsonism & Related Disorders.

“Frailty is common in Parkinson disease,” researchers wrote. “There is no agreed upon tool for identifying frailty, however, the importance of its identification is apparent given the high prevalence and the association between frailty and adverse outcomes in persons with Parkinson disease.”

The systematic review and meta-analysis included 30 studies reporting on frailty in people with Parkinson disease, 28 of which were observational. Five studies involved inpatients. Researchers noted that 40% of the included studies were published in 2019 or 2020, suggesting a growing interest in the subject.

In addition to identifying a 38% prevalence in patients under the frailty phenotype, the study identified several Parkinson disease characteristics associated with frailty. They included longer disease duration, higher motor impairment, non-tremor dominant Parkinson disease (postural instability/gait difficulty dominant phenotype), and higher daily levodopa dose.

A number of adverse outcomes were associated with frailty in affected patients, the study found, such as repeated falls, cognitive impairment and dementia, orthostatic hypotension, fatigue, hallucinations, nursing home placement, dependency in activities in daily living, and inpatient mortality.

“We propose that clinicians should routinely screen for frailty in patients with Parkinson disease,” researchers advised, “and that interventions to prevent and/or ameliorate these adverse outcomes should include: falls risk assessment, screening for cognitive impairment, orthostatic hypotension screening and management, screening for nonmotor symptoms of Parkinson disease such as fatigue and hallucinations, and monitoring of functional status.”

Reference:
McMillan JM, Michalchuk Q, Goodarzi Z. Frailty in Parkinson's disease: A systematic review and meta-analysis. Clin Park Relat Disord. 2021;4:100095. Published 2021 May 25. doi:10.1016/j.prdoa.2021.100095