The Relationship of Sarcopenia with Disease Stage and Activities of Daily Living in Parkinson's Patients

Abstract

Aim: Parkinson's disease (PD) is the second most common progressive neurodegenerative disease, presenting with motor and nonmotor findings. The relationship between clinical features and sarcopenia in Parkinson's patients is not clear, and the evaluation of this relationship is imperative in terms of preventing falls and disabilities. Our study aimed to describe the demographic and clinical characteristics of patients with PD and to evaluate the relationship between sarcopenia screening test and disease stage, walking speed, hand grip muscle strength, and activities of daily living. Material and Method: Male and female patients with clinically confirmed PD aged 50 years and older were included in the cross-sectional descriptive study. Disease staging was evaluated using the Hoehn-Yahr scale, walking speed with the Time Up and Go test (TUG), muscle strength with a hand dynamometer, activities of daily living with the Barthel Index, and the SARC-F test for sarcopenia. Results: Of the 52 patients included in the study, 40.4% were female and 59.6% were male, and the mean age was 69.86±8.14 years. SARC-F score was high in 51.4% of the patients. The disease stage was associated with an increase in SARC-F scores. The increase in SARC-F scores was positively correlated with the increase in the TUG test (p=0.028, r=0.306), while the SARC-F score was negatively correlated with activities of daily living. (p=0.000, r=-0.684). Eighty-one-point three percent of the women with low hand muscle strength had high SARC-F scores, and the difference between them was statistically significant. Conclusion: Our findings indicated that sarcopenia was prevalent among patients with PD, with its prevalence increasing in direct proportion to the progression of the disease. Furthermore, patients exhibiting high sarcopenia levels demonstrated reduced walking speed and impaired daily living abilities. These observations underscore the critical importance of incorporating sarcopenia evaluations into the development of rehabilitation programs for patients.

Keywords

• Parkinson
• sarcopenia
• disease stage
• daily living activities

Kaynakça

1. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008;79:368-76.
2. Hart A, Cordova-Rivera L, Barker F, Sayer AA, et al. The prevalence of sarcopenia in Parkinson’s disease and related disorders-a systematic review. Neurol Sci. 2023;44:4205-17.
3. Braak H, Del Tredici K, Rüb U, et al. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging. 2003;24:197-211.
4. Drey M, Hasmann SE, Krenovsky JP, et al. Associations between early markers of Parkinson's disease and sarcopenia. Front Aging Neurosci. 2017;9:53.
5. Bua EA, McKiernan SH, Wanagat J, et al. Mitochondrial abnormalities are more frequent in muscles undergoing sarcopenia. J Appl Physiol (1985). 2002;92:2617-24.
6. McMillan JM, Michalchuk Q, Goodarzi Z. Frailty in Parkinson’s disease: a systematic review and meta-analysis. Clin Park Relat Disord. 2021 May 25;4:100095.
7. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17:427-42.
8. Bahat G, Yilmaz O, Kılıç C, et al. Performance of SARC-F in regard to sarcopenia definitions, muscle mass and functional measures. J Nutr Health Aging. 2018;22:898-903.

9. Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr. 2014;14:14.
10. de Medeiros LC, da Luz MCL, da Costa Pereira JP, et al. Nutritional status and dynapenia in people living with Parkinson's disease: a cross-sectional study. Neurol Sci. 2022;43:2509-17.
11. Bohannon RW. Considerations and practical options for measuring muscle strength: a narrative review. Biomed Res Int. 2019;2019:8194537.
12. Barichella M, Pinelli G, Iorio L, et al. Sarcopenia and dynapenia in patients with parkinsonism. J Am Med Dir Assoc. 2016;17:640-6.
13. Trevisan C, Vetrano DL, Calvani R, et al. Twelve-year sarcopenia trajectories in older adults: results from a population-based study. J Cachexia Sarcopenia Muscle. 2022;13:254-63.
14. Petermann-Rocha F, Balntzi V, Gray SR, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2022;13:86-99.
15. Vetrano DL, Pisciotta MS, Laudisio A, et al. Sarcopenia in Parkinson disease: comparison of different criteria and association with disease severity. J Am Med Dir Assoc. 2018;19:523-7.
16. Lima DP, de Almeida SB, Bonfadini JC, et al. Clinical correlates of sarcopenia and falls in Parkinson's disease. PLoS One. 2020;15:e0227238.
17. Rolland Y, Dupuy C, Van Kan GA, et al. Sarcopenia screened by the SARC-F questionnaire and physical performances of elderly women: a cross-sectional study. J Am Med Dir Assoc. 2017;18:848-52.
18. Yılmaz N, Özmen G. Gender-assessment of attention functions in parkinson's patients: an fMRI study. European Journal of Science and Technolog. 2021;28:843-8.
19. Allen NE, Canning CG, Almeida LRS, et al. Interventions for preventing falls in Parkinson's disease. Cochrane Database Syst Rev. 2022;6:CD011574.
20. Cai Y, Feng F, Wei Q, et al. Sarcopenia in patients with Parkinson's disease: a systematic review and meta-analysis. Front Neurol. 2021;12:598035.
21. Şen A, Azizoğlu F, İlhan SE. Quality of life in Parkinson's patients roles of nurses and care givers. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2023;49:417-24.