Objective: To follow for two years pulmonary function and respiratory muscle strength tests of elderly people with Parkinson’s disease (PD).

Background: Respiratory disorders are common in PD individuals and influence morbidity, mortality and quality of life. However, most do not complain of any symptoms. This silent abnormality, coupled with the impaired cough reflex and dysphagia, may contribute to complications such as aspiration pneumonia. The most of studies conducted in this population are in the advanced stages of the disease.

Methods: Longitudinal study (at approximately two-year intervals). Inclusion criteria were people over sixty years old with PD, in the early stages (Modified Hoehn and Yahr- HY stage between 0 and 3) and currently treated with levodopa. Exclusion criteria included those who had smoked within the last five years, had other neurologic impairments, dementia, asthma, COPD, other breathing disorders, unstable cardiac conditions and that do not present physical/cognitive conditions for the performance of the tests adequately. A research ethics committee approved this study: CAAE 70479517.2.0000.5020. Spirometry were performed according to ATS/ERS criteria, while maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) was determined as previously described by Black and Hyatt in cm/H2O. Was performed statistical analysis using SPSS 17 software.

Results: Eighteen individuals were included, half of each sex, initially age median (Interquartile range) = 70 (65.75) years. Relative to functionality: 72% of the sample worsened the HY score, 11.1% improved and 16.7% did not change. In the first analyses, there was a high prevalence of ventilatory disturbance: 72.1%, being the restrictive disorder the most prevalent (p<0.001). With the exception of forced vital capacity, that was normal and remained the same, all the spirometric variables worsened after two years. There was increasing the prevalence of ventilatory disturbance for 94.4%, being the restrictive disorder the most prevalent: 53.8%. MIP and MEP were normal in the first assessment and reduced in the second (Mean: -88,2 ± SDM – 48,2 to -43,2 ± 29,2; p<0,001; +98,8 ± 33,9 to + 55,0 ± 32,9; p= 0,005), respectively.

Conclusions: There was a high prevalence of ventilatory disorder, even in the early stages of PD. Respiratory muscle strength worsens with the onset of the disease.

References: 1. TYSNES, O. B.; STORSTEIN, A. Epidemiology of Parkinson’s disease. Journal Neural Transm (Vienna). Aug;124(8):901-905. 2017. 2. DORSEY, E. R., BASTIAAN, R. B.. The Parkinson Pandemic – A Call to Action. JAMA Neurology November. 2017. 3. DE PABLO-FERNANDEZ, E. et al. Association of autonomic dysfunction with disease progression and survival in Parkinson disease. Jama Neurology, v. 74, n. 8, p. 970-976, 2017. 4. GONÇALVES, R. L. et al. Avaliação da função respiratória em indivíduos com doença de Parkinson the pulmonary function in Parkinsons disease. NBC-Periódico Científico do Núcleo de Biociências, v. 1, n. 2, p. 42-50, 2012. 5. SATHYAPRABHA, T. N. et al. Pulmonary functions in Parkinson’s disease. Indian journal of chest diseases and allied sciences, v. 47, n. 4, p. 251, 2005. 6. BAILLE, G et al. Ventilatory Dysfunction in Parkinson’s Disease. Journal of Parkinson’s Disease, [s.l.], v. 6, n. 3, p.463-471, 20 ago. 2016. 7. GONÇALVES, R. L. et al. Respiratory Function and the Influence of Inspiratory Muscle in Vital Capacity in Parkinsons Disease. J Nov Physiother, v. 6, n. 319, p. 2, 2016.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-pulmonary-function-and-respiratory-muscle-strength-tests-of-elderly-people-with-parkinsons-disease-a-two-year-observational-study/