The Association Between Frailty and Parkinson’s Disease in the ReSPOnD trial

Natalie Smith; Daisy M Gaunt; Alan L Whone; Yoav Ben-Shlomo; Emily J Henderson

doi:10.5770/CGJ.24.437

The Association Between Frailty and Parkinson’s Disease in the ReSPOnD trial

Natalie Smith^*, Daisy M Gaunt, Alan L Whone, Yoav Ben-Shlomo, Emily J Henderson

^*Corresponding author for this work

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Abstract

Background: Frailty and Parkinson’s disease (PD) are both highly prevalent in older people, but few studies have studied frailty in people with Parkinson’s. Identifying frailty in this population is vital, to target new interventions to those who would most benefit. Methods: Data were collected as part of the double-blind randomised controlled rivastigmine to stabilise gait ReSPonD trial in 130 people with Hoehn and Yahr 2-3, idiopathic PD who had fallen in the year prior to enrolment. Individuals were assessed at baseline and followed up at 8 months, including determination of frailty status. Results: 120 patients attended for follow-up. At follow-up, the mean (SD) age was 70.2 years (8.0), MDS-UPDRS total score 91.5 (29.1) and MDS-UPDRS motor score (Part III) 42.7 (14.8). Median disease duration was 9.2 years (IQR 4.6 to 13.1), Geriatric Depression Score 4 (IQR 2 to 6). Using the Fried frailty criteria, 31 (26%) were frail and 70 (58%) pre-frail. In univariable analysis, being female, higher depression score and MDS-UPDRS score was associated with greater frailty. Using ordinal regression, in the multivariable model, being female (Odds ratio [OR] 3.10, 95%CI 1.53 to 6.26, p=0.002), higher total MDS-UPDRS score (OR 2.02, 95%CI 1.42 to 2.87, p<0.0001) and higher depression (OR 1.47, 95%CI 1.05 to 2.06, p=0.03) were associated with higher number of frailty markers. Conclusion: There was a high prevalence (84%) of pre-frail and frail individuals in patients participating in this RCT. Future research should determine the optimum tool to assess frailty in this at-risk population and delineate the association between Parkinson’s, frailty and health outcomes.

Original language	English
Pages (from-to)	22-25
Number of pages	4
Journal	Canadian Geriatrics Journal
Volume	24
Issue number	1
DOIs	https://doi.org/10.5770/CGJ.24.437
Publication status	Published - 18 Feb 2021

Bibliographical note

Funding Information:
The ReSponD trial in which this study was nested was funded by a Parkinson’s UK career development award (F1003) awarded to Emily J. Henderson. The funder had no role in the study design or writing of the report.

Publisher Copyright:
© 2021 Author(s). Published by the Canadian Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivative license (http://creativecommons.org/licenses/by-nc-nd/2.5/ca/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited.

Keywords

Parkinson’s disease
frailty
ageing

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title = "The Association Between Frailty and Parkinson{\textquoteright}s Disease in the ReSPOnD trial",

abstract = "Background: Frailty and Parkinson{\textquoteright}s disease (PD) are both highly prevalent in older people, but few studies have studied frailty in people with Parkinson{\textquoteright}s. Identifying frailty in this population is vital, to target new interventions to those who would most benefit. Methods: Data were collected as part of the double-blind randomised controlled rivastigmine to stabilise gait ReSPonD trial in 130 people with Hoehn and Yahr 2-3, idiopathic PD who had fallen in the year prior to enrolment. Individuals were assessed at baseline and followed up at 8 months, including determination of frailty status. Results: 120 patients attended for follow-up. At follow-up, the mean (SD) age was 70.2 years (8.0), MDS-UPDRS total score 91.5 (29.1) and MDS-UPDRS motor score (Part III) 42.7 (14.8). Median disease duration was 9.2 years (IQR 4.6 to 13.1), Geriatric Depression Score 4 (IQR 2 to 6). Using the Fried frailty criteria, 31 (26%) were frail and 70 (58%) pre-frail. In univariable analysis, being female, higher depression score and MDS-UPDRS score was associated with greater frailty. Using ordinal regression, in the multivariable model, being female (Odds ratio [OR] 3.10, 95%CI 1.53 to 6.26, p=0.002), higher total MDS-UPDRS score (OR 2.02, 95%CI 1.42 to 2.87, p<0.0001) and higher depression (OR 1.47, 95%CI 1.05 to 2.06, p=0.03) were associated with higher number of frailty markers. Conclusion: There was a high prevalence (84%) of pre-frail and frail individuals in patients participating in this RCT. Future research should determine the optimum tool to assess frailty in this at-risk population and delineate the association between Parkinson{\textquoteright}s, frailty and health outcomes. ",

keywords = "Parkinson{\textquoteright}s disease, frailty, ageing",

author = "Natalie Smith and Gaunt, {Daisy M} and Whone, {Alan L} and Yoav Ben-Shlomo and Henderson, {Emily J}",

note = "Funding Information: The ReSponD trial in which this study was nested was funded by a Parkinson{\textquoteright}s UK career development award (F1003) awarded to Emily J. Henderson. The funder had no role in the study design or writing of the report. Publisher Copyright: {\textcopyright} 2021 Author(s). Published by the Canadian Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivative license (http://creativecommons.org/licenses/by-nc-nd/2.5/ca/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited.",

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language = "English",

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AU - Smith, Natalie

AU - Gaunt, Daisy M

AU - Whone, Alan L

AU - Ben-Shlomo, Yoav

AU - Henderson, Emily J

N1 - Funding Information: The ReSponD trial in which this study was nested was funded by a Parkinson’s UK career development award (F1003) awarded to Emily J. Henderson. The funder had no role in the study design or writing of the report. Publisher Copyright: © 2021 Author(s). Published by the Canadian Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivative license (http://creativecommons.org/licenses/by-nc-nd/2.5/ca/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited.

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N2 - Background: Frailty and Parkinson’s disease (PD) are both highly prevalent in older people, but few studies have studied frailty in people with Parkinson’s. Identifying frailty in this population is vital, to target new interventions to those who would most benefit. Methods: Data were collected as part of the double-blind randomised controlled rivastigmine to stabilise gait ReSPonD trial in 130 people with Hoehn and Yahr 2-3, idiopathic PD who had fallen in the year prior to enrolment. Individuals were assessed at baseline and followed up at 8 months, including determination of frailty status. Results: 120 patients attended for follow-up. At follow-up, the mean (SD) age was 70.2 years (8.0), MDS-UPDRS total score 91.5 (29.1) and MDS-UPDRS motor score (Part III) 42.7 (14.8). Median disease duration was 9.2 years (IQR 4.6 to 13.1), Geriatric Depression Score 4 (IQR 2 to 6). Using the Fried frailty criteria, 31 (26%) were frail and 70 (58%) pre-frail. In univariable analysis, being female, higher depression score and MDS-UPDRS score was associated with greater frailty. Using ordinal regression, in the multivariable model, being female (Odds ratio [OR] 3.10, 95%CI 1.53 to 6.26, p=0.002), higher total MDS-UPDRS score (OR 2.02, 95%CI 1.42 to 2.87, p<0.0001) and higher depression (OR 1.47, 95%CI 1.05 to 2.06, p=0.03) were associated with higher number of frailty markers. Conclusion: There was a high prevalence (84%) of pre-frail and frail individuals in patients participating in this RCT. Future research should determine the optimum tool to assess frailty in this at-risk population and delineate the association between Parkinson’s, frailty and health outcomes.

AB - Background: Frailty and Parkinson’s disease (PD) are both highly prevalent in older people, but few studies have studied frailty in people with Parkinson’s. Identifying frailty in this population is vital, to target new interventions to those who would most benefit. Methods: Data were collected as part of the double-blind randomised controlled rivastigmine to stabilise gait ReSPonD trial in 130 people with Hoehn and Yahr 2-3, idiopathic PD who had fallen in the year prior to enrolment. Individuals were assessed at baseline and followed up at 8 months, including determination of frailty status. Results: 120 patients attended for follow-up. At follow-up, the mean (SD) age was 70.2 years (8.0), MDS-UPDRS total score 91.5 (29.1) and MDS-UPDRS motor score (Part III) 42.7 (14.8). Median disease duration was 9.2 years (IQR 4.6 to 13.1), Geriatric Depression Score 4 (IQR 2 to 6). Using the Fried frailty criteria, 31 (26%) were frail and 70 (58%) pre-frail. In univariable analysis, being female, higher depression score and MDS-UPDRS score was associated with greater frailty. Using ordinal regression, in the multivariable model, being female (Odds ratio [OR] 3.10, 95%CI 1.53 to 6.26, p=0.002), higher total MDS-UPDRS score (OR 2.02, 95%CI 1.42 to 2.87, p<0.0001) and higher depression (OR 1.47, 95%CI 1.05 to 2.06, p=0.03) were associated with higher number of frailty markers. Conclusion: There was a high prevalence (84%) of pre-frail and frail individuals in patients participating in this RCT. Future research should determine the optimum tool to assess frailty in this at-risk population and delineate the association between Parkinson’s, frailty and health outcomes.

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KW - frailty

KW - ageing

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DO - 10.5770/CGJ.24.437

M3 - Article (Academic Journal)

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VL - 24

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EP - 25

JO - Canadian Geriatrics Journal

JF - Canadian Geriatrics Journal

SN - 1925-8348

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ER -

The Association Between Frailty and Parkinson’s Disease in the ReSPOnD trial

Abstract

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