Objective: This study aimed to determine whether Sarcopenia is related to the risk of falls and to the Fear of Falling (FOF) in patients with Parkinson’s disease (PD).

Background: Sarcopenia is a progressive and generalised skeletal muscle disorder that is associated with increased likelihood of adverse outcomes, sharing several common pathophysiological mechanisms with PD.

Method: Sarcopenia diagnosis was confirmed by using an initial screening tool for sarcopenia, the SARC-F questionnaire (score ≥4 sarcopenia). Sarcopenia  was assessed also according to handgrip strength cutoffs (<27 kg for men and <16 kg for women). FOF was assessed with the FES international questionnaire and patients with score over 27 were considered as having FOF.  Falls within the last 12 months were assessed via patient self-report, with caregiver confirmation when necessary.

Results: Overall, 95 patients with PD (65 males)  were included. The mean age was 64.2±8.9 years and mean disease duration was 8.9±6.3 years. 28% were screened positive for sarcopenia using the SARC-F and 20% with handgrip strength. Sarcopenia was found more prevelant in women. 40% of the patients were classified as having FOF.  A significant relationship between sarcopenia and the occurrence of falls in patients was found using both SARC-F (χ² = 36.357, p < 0.01) or handgrip strength (χ² = 5.197,p<0.05). Regarding FOF assessment using FES-I the analysis revealed a statistically significant association with both SARC-F (χ²= 29.774,p<0.01) and handgrip strength (χ² = 7.963,p<0.05). A binary logistic regression was performed to examine the factors influencing falls. The analysis included SARC-F scores, age, and disease duration as predictors. Higher SARC-F scores were associated with increased odds of falls (OR 2.77, 95%CI 1.77–4.31,p<0.001), suggesting that sarcopenia is a strong predictor of falls. Concerning FOF the same steps were followed (OR 1.72, 95% CI 1.27–2.34, p < 0.001). A ROC analysis was performed and the value of AUC was 0.93 in fall model and 0.81 in FOF, indicating that both models have excellent discriminative ability.

Conclusion: PD patients with sarcopenia are more likely to experience falls. Moreover, sarcopenia might be an important contributing factor to experience FOF. The SARC-F score could be used as a simple and effective tool to identify individuals at risk for falls or FOF.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-of-sarcopenia-with-fear-of-falling-and-falls-in-patients-with-parkinsons-disease/