Cross-Sectional and Prospective Associations between Parkinsonism and Parkinson's Disease with Frailty in Latin America

Dani J Kim; Nusrat Khan; Juan J Llibre-Rodriguez; Miao Jiang; Ana M Rodriguez-Salgado; Isaac Acosta; Ana Luisa Sosa; Daisy Acosta; Ivonne Z Jimenez-Velasquez; Mariella Guerra; Aquiles Salas; Nedelys Díaz Sánchez; Ricardo López-Contreras; Heike Hesse; Caroline Tanner; Jorge J Llibre-Guerra; Matthew Prina

doi:10.1002/mdc3.14214

Cross-Sectional and Prospective Associations between Parkinsonism and Parkinson's Disease with Frailty in Latin America

Mov Disord Clin Pract. 2024 Sep 20. doi: 10.1002/mdc3.14214. Online ahead of print.

Authors

Dani J Kim^{1

2}, Nusrat Khan², Juan J Llibre-Rodriguez³, Miao Jiang⁴, Ana M Rodriguez-Salgado⁵, Isaac Acosta^{6

7}, Ana Luisa Sosa^{6

7}, Daisy Acosta⁸, Ivonne Z Jimenez-Velasquez⁹, Mariella Guerra¹⁰, Aquiles Salas¹¹, Nedelys Díaz Sánchez⁴, Ricardo López-Contreras¹², Heike Hesse¹³, Caroline Tanner¹⁴, Jorge J Llibre-Guerra¹⁵, Matthew Prina^{1

2}

Affiliations

¹ Health Service and Population Research Department, Institute of Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
² Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
³ Dementia Research Unit, Medical University of Havana, Havana, Cuba.
⁴ Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland.
⁵ Global Brain Health Institute, University of San Francisco California, San Francisco, California, USA.
⁶ Laboratory of the Dementias, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
⁷ National Autonomous University of Mexico, Mexico City, Mexico.
⁸ Universidad Nacional Pedro Henriquez Ureña (UNPHU), Internal Medicine Department, Geriatric Section, Santo Domingo, Dominican Republic.
⁹ Internal Medicine Department, Geriatrics Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
¹⁰ Instituto de la Memoria Depresion y Enfermedades de Riesgo IMEDER, Lima, Peru.
¹¹ Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela.
¹² Memory Clinic, Neurology Service, Salvadoran Social Security Institute, San Salvador, El Salvador.
¹³ Observatorio Covid-19, Universidad Tecnológica Centroamericana, Tegucigalpa, Honduras.
¹⁴ Department of Neurology, Weill Institute for Neurosciences, University of California-San Francisco, San Francisco, California, USA.
¹⁵ Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.

PMID: 39305017
DOI: 10.1002/mdc3.14214

Abstract

Background: Little is known about the relationship between parkinsonism or Parkinson's disease (PD) and frailty in Latin America.

Objective: The study aimed to determine the cross-sectional and prospective associations between parkinsonism and PD with frailty in a large multi-country cohort in Latin America. Frailty was assessed using three different models to explore which definitions are more appropriate to screen for frailty in a PD population.

Methods: 12,865 older adults (aged ≥65 years) from the 10/66 population-based cohort study in six Latin American countries were analyzed. Logistic regression models assessed the cross-sectional association between parkinsonism/PD with baseline frailty. Individual country analyses were combined via fixed-effect meta-analysis. In non-frail participants who were followed up for 4 years, Cox proportional hazards regression models assessed the prospective association between parkinsonism/PD with incident frailty accounting for competing risk of mortality.

Results: At baseline, the prevalence of parkinsonism and PD was 7% and 2%, respectively, and the prevalence of frailty varied across the three models with rates of 18% for frailty phenotype, 20% for frailty index and 30% for multidimensional frailty model. PD was associated with baseline and incident frailty after accounting for age, sex, and education: odds ratios and 95% confidence intervals (95% CI) for frailty were 2.49 (95% CIs 1.87-3.31), 2.42 (95% CIs 1.80-3.25), and 1.57 (95% CIs 1.16-2.21), and cause-specific hazard ratios were 1.66 (95% CIs 1.07-2.56), 1.78 (95% CIs 1.05-3.03), and 1.58 (95% CIs 0.91-2.74). Similar results were found for parkinsonism.

Conclusion: Parkinsonism and PD were cross-sectionally and prospectively associated with frailty in Latin America. Routine screening for frailty in PD patients may aid earlier detection of those at greater risk of adverse outcomes.

Keywords: Latin America; Parkinson's disease; epidemiology; frailty.

Abstract

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