Frailty and Prodromal Parkinson’s Disease: Results From the HELIAD Study

2020 ◽  
Author(s):  
Eva Ntanasi ◽  
Maria Maraki ◽  
Mary Yannakoulia ◽  
Maria Stamelou ◽  
Georgia Xiromerisiou ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Frailty Index ◽  
Disease Diagnosis ◽  
Community Dwelling ◽  
Older Individuals ◽  
Linear Regression Models ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Underlying Mechanisms

Abstract Background To investigate the association between frailty, Parkinson’s disease (PD), and the probability of prodromal Parkinson’s disease (prodromal PD) in Greek community-dwelling older individuals. Methods Parkinson’s disease diagnosis was reached through standard clinical research procedures. Probability of prodromal PD was calculated according to the International Parkinson and Movement Disorder Society’s research criteria for PD-free participants. Frailty was evaluated according to definitions of the phenotypic and multidomain approach. Logistic and linear regression models were performed to investigate associations between frailty (predictor) and the probability of prodromal PD, either continuous or dichotomous (≥30% probability score), or PD (outcome). Results Data from 1765 participants aged 65 and older were included in the present analysis. Parkinson’s disease and prodromal PD prevalence were 1.9% and 3.0%, respectively. Compared to nonfrail participants, those who were frail, as identified with either the Fried frailty phenotype or Frailty Index had approximately 4 (odds ratio [OR] 4.09, 95% confidence interval [CI] 1.54–10.89) and 12 times (OR 12.16, 95% CI 5.46–27.09) higher odds of having a PD diagnosis, respectively. Moreover, compared to the nonfrail, frail participants as identified with either the Fried frailty phenotype or Frailty Index had 2.8 (OR 2.83, 95% CI 1.09–7.37) and 8.3 times (OR 8.39, 95% CI 4.56–15.42) higher odds of having possible/probable prodromal PD, respectively. Conclusions Frailty status was associated with prodromal PD and PD, suggesting common characteristics or underlying mechanisms of these conditions. Although prospective studies are warranted, acknowledging the possible association of frailty, PD, and prodromal PD may improve their clinical management.

CONCURRENCE OF FRAILTY AND PARKINSON’S DISEASE

2012 ◽  
pp. 1-5
Author(s):  
K.P. ROLAND ◽  
K.M.D. CORNETT ◽  
O. THEOU ◽  
J.M. JAKOBI ◽  
G.R. JONES
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cardiovascular Health ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Levodopa Dose ◽  
Frailty Phenotype ◽  
Age Related

Background: Females with Parkinson’s disease (PD) are at greater risk of frailty than males. Little is known about how age and disease-related characteristics influence frailty in females with PD because frailty studies often exclude persons with underlying neurological pathologies. Objective: To determine age and diseaserelated characteristics that best explain physical frailty in community-dwelling females with and without PD. Design & Measurement: Correlation coefficients described relationships between PD-related characteristics and physical frailty phenotype criteria (Cardiovascular Health Study). Regression analysis identified associations between disease-related characteristics and frailty in non-PD and PD females. Setting: Community-dwelling. Participants: Females with mild to moderate PD (n = 17, mean age = 66 ± 8.5 years) and non-PD (n = 18, mean age = 72 ± 13.2 years) participated. Results: Daily carbidopa-levodopa dose best explained frailty in PD females (β = 0.5), whereas in non-PD females, age (β = 0.7) and comorbidity (β = 0.5) were most associated with frailty. Conclusions: Dopaminergic medication explained frailty in PD and not measures of disease progression (i.e. severity, duration). In females without PD age-related accumulation of comorbidities resulted in greater risk of frailty. This indicates dopaminergic management of PD symptoms may better reflect frailty in females with PD than disease severity or duration. These data suggest the influence of underlying frailty should be considered when managing neurological conditions. Understanding how frailty concurrently exists with PD and how these conditions progress within the aging female will facilitate future care management.

scholarly journals Letter to the Editor: Exploring Associations Between Oral Health and Frailty in Community-Dwelling Older People

2021 ◽  
pp. 1-1
Author(s):  
R.C. Castrejón-Pérez
Keyword(s):  
Oral Health ◽  
Older People ◽  
Medical Record ◽  
Frailty Index ◽  
Community Dwelling ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Frailty Status ◽  
Community Dwelling Older People ◽  
Oral Conditions

The studies exploring the association between oral conditions and Frailty status are increasing in number, and many manuscripts have been published during the last couple of years. Even when Everaars et al. (1) manuscript is cross-sectional, it contributes to the knowledge by confirming the association between oral conditions and Frailty despite the selected strategy for measuring Frailty since authors added the interview Groningen Frailty Index and the Frailty Index (computed with data extracted from the Electronic Medical Record) to the most frequently used Frailty Phenotype and Kihon checklist (2).

Validation of a deficit-accumulation Frailty Index in the ASPREE study and its predictive capacity for disability-free survival

2021 ◽  
Author(s):  
Joanne Ryan ◽  
Sara Espinoza ◽  
Michael E Ernst ◽  
A R M Saifuddin Ekram ◽  
Rory Wolfe ◽  
...  
Keyword(s):  
Physical Disability ◽  
Frailty Index ◽  
Community Dwelling ◽  
Older Individuals ◽  
Deficit Accumulation ◽  
Predictive Capacity ◽  
Frailty Phenotype ◽  
Adverse Health Outcomes ◽  
Risk Of Disease ◽  
Independent Life

Abstract Frailty is a state of heightened vulnerability and susceptibility to physiologic stressors that increases with age. It has shown increasing utility in predicting a range of adverse health outcomes. Here, we characterise a 67-item deficit-accumulation frailty index (FI) in 19,110 community-dwelling individuals in the ASPREE clinical trial. Participants aged 65 to 98 years were recruited from the U.S. and Australia, and were without diagnosed dementia and cardiovascular disease, and without major physical disability. The median FI score was 0.10 (IQR: 0.07; 0.14) at baseline, and the prevalence of frailty (FI> 0.21) increased from 8.1% to 17.4% after six years. FI was positively associated with age, and women had significantly higher scores than men at all ages. The FI was negatively correlated with gait speed (r =-0.31) and grip strength (r = -0.46), and strongly associated with a modified Fried frailty phenotype (p<0.0001, for all comparisons). Frailty was associated with the primary composite outcome capturing independent life lived free of major disability and dementia, and increased the rate of persistent physical disability (HR:21.3, 95% CI:15.6-28.9). It added significantly to the predictive capacity of these outcomes above age, sex and ethnicity alone. The FI is thus a useful biomarker of aging even among relatively healthy older individuals, and provides important information about an individual’s vulnerability to and risk of disease.

scholarly journals The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review

2020 ◽  
Author(s):  
A R M Saifuddin Ekram ◽  
Robyn Woods ◽  
Carlene Britt ◽  
Sara E Espinoza ◽  
Michael E Ernst ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Critical Appraisal ◽  
Frailty Index ◽  
Community Dwelling ◽  
Older Individuals ◽  
Umbrella Review ◽  
Frailty Phenotype ◽  
Essential Information ◽  
All Cause Mortality ◽  
Meta Analyses

Abstract Background Frailty is associated with multiple adverse health outcomes, including mortality. Several methods have been used to characterize frailty, each based on different frailty scales. These include scales based on a phenotype, multidomain, and deficit accumulations. Several systematic reviews have examined the association between frailty and mortality; however, it is unclear whether these different frailty scales similarly predict mortality. This umbrella review aims to examine the association between frailty assessed by different frailty scales and all-cause mortality among community-dwelling older adults. Methods The umbrella review protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched to identify systematic reviews and meta-analyses examining the association between frailty and all-cause mortality. Methodological quality was assessed using the JBI. Critical Appraisal Checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Results Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All the systematic reviews performed meta-analyses and assessed between-study heterogeneity. All of the systematic reviews found that frailty was significantly associated with all-cause mortality.Conclusion This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.

scholarly journals Prevalence of Physical Frailty: Results from the DO-HEALTH Study

2021 ◽  
pp. 1-8
Author(s):  
M. Gagesch ◽  
P.O. Chocano-Bedoya ◽  
L.A. Abderhalden ◽  
G. Freystaetter ◽  
A. Sadlon ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Frailty Index ◽  
Female Gender ◽  
Community Dwelling ◽  
Health Study ◽  
Geriatric Syndrome ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Frailty Status

Background: Frailty is a geriatric syndrome associated with multiple negative health outcomes. However, its prevalence varies by population and instrument used. We investigated frailty and pre-frailty prevalence by 5 instruments in community-dwelling older adults enrolled to a randomized-controlled trial in 5 European countries. METHODS: Cross-sectional baseline analysis in 2,144 DO-HEALTH participants recruited from Switzerland, Austria, France, Germany, and Portugal with complete data for frailty. Frailty status was assessed by the Physical Frailty Phenotype [PFP], SOF-Frailty Index [SOF-FI], FRAIL-Scale, SHARE-Frailty Instrument [SHARE-FI], and a modified SHARE-FI, and compared by country, age, and gender. Logistic regression was used to determine relevant factors associated with frailty and pre-frailty. RESULTS: Mean age was 74.9 (±4.4) years, 61.6% were women. Based on the PFP, overall frailty and pre-frailty prevalence was 3.0% and 43.0%. By country, frailty prevalence was highest in Portugal (13.7%) and lowest in Austria (0%), and pre-frailty prevalence was highest in Portugal (57.3%) and lowest in Germany (37.1%). By instrument and overall, frailty and pre-frailty prevalence was highest based on SHARE-FI (7.0% / 43.7%) and lowest based on SOF-FI (1.0% / 25.9%). Frailty associated factors were residing in Coimbra (Portugal) [OR 12.0, CI 5.30-27.21], age above 75 years [OR 2.0, CI 1.17-3.45], and female gender [OR 2.8, CI 1.48-5.44]. The same three factors predicted pre-frailty. CONCLUSIONS: Among relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.

scholarly journals Frequency of Parkinsonism and Parkinson Disease in African Americans in the Chicago Community

2021 ◽  
Author(s):  
Meagan Bailey ◽  
Lisa M Shulman ◽  
Diane Ryan ◽  
Bichun Ouyang ◽  
Joshua M Shulman ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cohort Studies ◽  
Rating Scale ◽  
Community Dwelling ◽  
Self Report ◽  
Older Individuals ◽  
Cognitive Differences ◽  
Disease Rating ◽  
And Gender

Abstract Background There is paucity of data about African American (AA) patients with Parkinson’s disease (PD) and parkinsonism which may precede PD in older adults. Prior studies suggest that there are lower rates of PD in the AA population, with more cognitive impairment in AA with PD. This study aimed to investigate differences in PD, parkinsonism, and cognition between White and AA populations in 3 longitudinal epidemiologic cohort studies of aging. Methods This study examined parkinsonism, PD frequency, and cognition of community-dwelling older individuals in 3 longitudinal epidemiologic cohort studies. Parkinsonism was based on an exam utilizing the modified Unified Parkinson’s Disease Rating Scale performed by a nurse. PD was based on self-report, medications used for treatment of PD, and examination findings. Cognition was assessed using 19 performance-based tests that assess 5 cognitive domains. Results AA participants were less likely to have parkinsonism compared to Whites, even with age and gender differences. Frequency of PD was not significant between groups. AA were more likely to have lower cognitive scores as compared to Whites. AA were less likely to have parkinsonism even with controlling for cognitive differences between groups. Conclusions Parkinsonian signs are present among AA in the community at lower rates than in White individuals. Cognitive profiles of AA and Whites with parkinsonism may be different, suggesting differing contributions of pathology to cognitive decline and parkinsonism between groups. Additional research is needed to understand the progression of parkinsonism to PD, as well as to understanding the cognitive differences in AA with parkinsonism.

scholarly journals Frailty state utility and minimally important difference: findings from the North West Adelaide Health Study

2020 ◽  
Author(s):  
Mark Q Thompson ◽  
Olga Theou ◽  
Julie Ratcliffe ◽  
Graeme R Tucker ◽  
Robert J Adams ◽  
...  
Keyword(s):  
Dynamic Condition ◽  
Short Form ◽  
Frailty Index ◽  
Community Dwelling ◽  
Health Study ◽  
Economic Evaluations ◽  
Minimally Important Difference ◽  
Health State ◽  
Frailty Phenotype ◽  
Frailty Status

Abstract Background frailty is a dynamic condition for which a range of interventions are available. Health state utilities are values that represent the strength of an individual’s preference for specific health states, and are used in economic evaluation. This is a topic yet to be examined in detail for frailty. Likewise, little has been reported on minimally important difference (MID), the extent of change in frailty status that individuals consider to be important. Objectives to examine the relationship between frailty status, for both the frailty phenotype (FP) and frailty index (FI), and utility (preference-based health state), and to determine a MID for both frailty measures. Design and setting population-based cohort of community-dwelling Australians. Participant in total, 874 adults aged ≥65 years (54% female), mean age 74.4 (6.2) years. Measurements frailty was measured using the FP and FI. Utilities were calculated using the short-form 6D health survey, with Australian and UK weighting applied. MID was calculated cross-sectionally. Results for both the FP and FI, frailty was significantly statistically associated (P < 0.001) with lower utility in an adjusted analysis using both Australian and UK weighting. Between-person MID for the FP was identified as 0.59 [standard deviation (SD) 0.31] (anchor-based) and 0.59 (distribution-based), whereas for the FI, MID was 0.11 (SD 0.05) (anchor-based) and 0.07 (distribution-based). Conclusions frailty is significantly associated with lower preference-based health state utility. Frailty MID can be used to inform design of clinical trials and economic evaluations, as well as providing useful clinical information on frailty differences that patients consider important.

scholarly journals The Association Between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review

2021 ◽  
pp. 1-7
Author(s):  
A.R.M.S. Ekram ◽  
R.L. Woods ◽  
C. Britt ◽  
S. Espinoza ◽  
M.E. Ernst ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Critical Appraisal ◽  
Frailty Index ◽  
Community Dwelling ◽  
Older Individuals ◽  
Umbrella Review ◽  
Deficit Accumulation ◽  
Frailty Phenotype ◽  
Essential Information ◽  
All Cause Mortality

Frailty is associated with multiple adverse health outcomes, including mortality. Several methods have been used to characterize frailty, each based on different frailty scales. These include scales based on phenotype, multidomain, and deficit accumulations. Several systematic reviews have examined the association between frailty and mortality; however, it is unclear whether these different frailty scales similarly predict mortality. This umbrella review aims to examine the association between frailty assessed by different frailty scales and all-cause mortality among community-dwelling older adults. A protocol was registered at PROSPERO, and it was conducted following the PRISMA statement. MEDLINE, Embase, PubMed, Cochrane Database of Systematic Reviews, Joanna Briggs Institute (JBI) EBP database, and Web of Science database was searched. Methodological quality was assessed using the JBI critical appraisal checklist and online AMSTAR-2 critical appraisal checklist. For eligible studies, essential information was extracted and synthesized qualitatively. Five systematic reviews were included, with a total of 434,115 participants. Three systematic reviews focused on single frailty scales; one evaluated Fried’s physical frailty phenotype and its modifications; another focused on the deficit accumulation frailty index. The third evaluated the FRAIL (Fatigue, Resistance, Ambulation, Illness, and Loss of weight) scale. The two other systematic reviews determined the association between frailty and mortality using different frailty scales. All of the systematic reviews found that frailty was significantly associated with all-cause mortality. This umbrella review demonstrates that frailty is a significant predictor of all-cause mortality, irrespective of the specific frailty scale.

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