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

• Published in: Movement disorders clinical practice (Hoboken, N.J.) Vol. 11; no. 12; pp. 1489 - 1499
• Main Authors: Kim, Dani J., Khan, Nusrat, Llibre‐Rodriguez, Juan J., Jiang, Miao, Rodriguez‐Salgado, Ana M., Acosta, Isaac, Sosa, Ana Luisa, Acosta, Daisy, Jimenez‐Velasquez, Ivonne Z., Guerra, Mariella, Salas, Aquiles, Sánchez, Nedelys Díaz, López‐Contreras, Ricardo, Hesse, Heike, Tanner, Caroline, Llibre‐Guerra, Jorge J., Prina, Matthew
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.12.2024
• Subjects: Aged; Aged, 80 and over; Cohort Studies; Cross-Sectional Studies; epidemiology; Female; Frail Elderly - statistics & numerical data; frailty; Frailty - epidemiology; Humans; Latin America; Latin America - epidemiology; Male; Parkinson Disease - complications; Parkinson Disease - epidemiology; Parkinson's disease; Parkinsonian Disorders - epidemiology; Prevalence; Prospective Studies; Latin America; epidemiology; frailty; Parkinson's disease; Latin America
• ISSN: 2330-1619; 2330-1619
• DOI: 10.1002/mdc3.14214

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.