Objective: To examine whether the MetaboHealth score, a blood-based composite score indicating metabolic frailty, provides added predictive insights into motor symptom severity and two-year motor progression, beyond common lifestyle and cardiometabolic determinants.
Background: Promising evidence suggests that metabolic pathways are altered in people with Parkinson’s disease (PwPD), and may be associated with motor progression. Better characterization of metabolic frailty could help identify individuals most likely to benefit from lifestyle and pharmacological interventions.
Method: MetaboHealth scores were compared between 588 PwPD and 108 controls from the ProPark cohort, adjusting for age and gender. PwPD were divided into tertiles based on MetaboHealth scores. Demographic, disease-related, lifestyle, and cardiometabolic were compared between the tertiles. Linear regression models assessed whether MetaboHealth predicts motor severity (Movement Disorders Society Unified Parkinson’s Disease Rating Scale part 3 (MDS-UPDRS-III total score) and two-year progression (change in MDS-UPDRS-III total score), adjusting for demographic, lifestyle, and cardiometabolic covariates.
Results: PwPD had an unfavorable metabolic profile (i.e. higher MetaboHealth) compared to controls, independent of age and gender (p=0.001). MetaboHealth tertiles differed in age (p<0.001), gender (p<0.001), postural instability/gait difficulty subtype (p<0.001), Hoehn & Yahr stage (p=0.003), time spent in moderate-to-vigorous physical activity (p=0.003), type 2 diabetes (p<0.001) and cardiovascular disease (p=0.0495). Metabolic frailty was associated with motor severity (β=1.301, 95% CI=0.225,2.377), but this association was no longer significant after including lifestyle and cardiometabolic determinants (β=1.066, 95% CI=-0.033,2.165). Metabolic frailty was not a significant predictor for disease progression (β=-0.250, 95% CI=-1.553, 1.054), independent of lifestyle and cardiometabolic determinants.
Conclusion: PwPD exhibit higher metabolic frailty than controls. Although metabolic frailty was associated with greater motor severity at baseline, this association was largely explained by lifestyle and cardiometabolic factors. MetaboHealth did not predict motor progression over two years, suggesting limited added prognostic value beyond established determinants.
To cite this abstract in AMA style:
M. Mijnsbergen, R. Weijer, L. Kuijer, J. van Hilten, J. Deelen, D. Hepp. Metabolic Frailty Shows Limited Predictive Insights into Motor Severity and Progression in Parkinson’s Disease Beyond Lifestyle and Cardiometabolic Determinants [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/metabolic-frailty-shows-limited-predictive-insights-into-motor-severity-and-progression-in-parkinsons-disease-beyond-lifestyle-and-cardiometabolic-determinants/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/metabolic-frailty-shows-limited-predictive-insights-into-motor-severity-and-progression-in-parkinsons-disease-beyond-lifestyle-and-cardiometabolic-determinants/