Objective: To assess the prevalence of frailty and its association with disease features in patients with Parkinson´s disease (PD).

Background: Frailty is a multifactorial syndrome affecting 4 to 27.3% of the general elderly with a weighted average of 9.9%. It is an important determinant of quality of life, disability, and mortality. However, data on the frequency and clinical associations of frailty in PD is very limited.

Methods: In this case-control study, we included 104 PD patients from a tertiary center and 330 non-PD controls from a population-based cohort aged >65 years. All groups were screened using the Clinical Frailty Scale of the Canadian Study of Health and Aging. Moreover, patients were evaluated for motor and non-motor symptoms, quality of life (QoL), and their level of dependency.

Results: The prevalence of frailty was 35.6% (27–45.2%) in PD patients compared to 5.2% (3.2–8.1%; p<0.001) in the community-based sample. In univariate regression models frailty was significantly associated with older age (p=0.03), longer disease duration (p<0.001), a higher Charlson Comorbidity Index (p=0.005), recurrent falls (p=0.001), and the non-tremor-dominant (TD) type of PD (p=0.002). The Hoehn and Yahr (H&Y) stage and all MDS-UPDRS scores were higher among frail compared with non-frail PD patients (p=<0.001 – 0.005). In addition, cognitive impairment (p=0.003), dementia (p<0.001), fatigue (p=0.03), and hallucinations (p=0.03) were independently associated with frailty. When adjusting for sex, age, and comorbidities, the multivariate logistic regression analysis revealed significant associations of frailty with longer disease duration (p=0.001), the non-TD type of PD (p=0.002), higher H&Y stages (p<0.001), higher MDS-UPDRS scores (p=<0.001 – 0.008), recurrent falls (p=0.003), as well as cognitive impairment (p=0.01), dementia (p=0.001) and hallucinations (p=0.02). Furthermore, frail PD patients were more frequently institutionalized (p=0.02) and dependent (p<0.001), and had higher PDQ-8 sum score values (p<0.001). There was no significant association between frailty and depression, autonomic features, or apathy in PD patients.

Conclusions: Frailty is more common in PD patients than in the general elderly population and is associated with older age, more advanced disease stages, a higher motor and non-motor burden, reduced QoL as well as institutionalization.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-characteristics-of-frailty-in-parkinsons-disease/