The role of frailty in Parkinson's disease: a cross-sectional study

Background Frailty is an age-related state of increased risk for health-related adverse outcomes that reflects multisystem physiological changes and likely influences the clinical expression and disease progression of neurodegenerative disorders. The aim of the present study was to assess the potential relationship between frailty, as assessed by a frailty index (FI), and motor symptom severity, motor subtypes, and non-motor domains in Parkinson's disease (PD). Methods We consecutively enrolled 150 PD patients. We administered an FI specifically designed for PD that included 50 age-related multidimensional biological deficits. Patients underwent a clinical assessment that evaluated motor and non-motor manifestations of PD. Using the FI score, we classified PD patients as relatively fit (FI <= 0.10), less fit (0.10 < FI <= 0.21), or frail (FI > 0.21). A linear regression model was designed to explore possible associations between frailty level and PD motor and non-motor manifestations. Results Frail patients showed greater motor symptom severity and motor complications than fitter patients. A trend towards a higher prevalence of the postural instability/gait disorder subtype was also observed in frail versus relatively fit and less fit patients. The global burden of non-motor symptoms was higher in frail patients. Increased frailty was associated with more severe motor and non-motor symptoms, as well as with more pronounced cognitive deficits. These associations remained significant even when traditional predictors of PD severity (age, disease duration, and levodopa equivalent daily dose) were considered. Conclusions The present findings indicate that the FI is associated with both motor and non-motor features of PD.

Automated summary

The study revealed that frailty in PD patients is associated with both motor and non-motor symptoms, with frail patients exhibiting more severe motor symptoms, higher global burden of non-motor symptoms, and pronounced cognitive deficits. The associations between frailty and symptom severity remained significant even after accounting for traditional predictors of PD severity.