Frailty status and its influencing factors in elderly Parkinson’s disease patients_West China Medical Journal

Authors：

CHEN Mengyuan ¹ , WANG Qiuqin ¹ , LIU Jie ¹ , ZHANG Xinyue ¹ , CHEN Juping ² , WANG Qunjuan ² ,  XU Guihua ¹

1. School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, P. R. China;
2. Department of Neurology, Changshu Hospital of Traditional Chinese Medicine, Changshu, Jiangsu 215500, P. R. China;

Corresponding author：

XU Guihua, Email: 7115@njucm.edu.cn

Keywords：

Parkinson’s disease; elderly people; frailty; influencing factor

DOI：

10.7507/1002-0179.202409024

Video：

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Objective To understand the frailty status and main influencing factors of elderly Parkinson’s disease (PD) patients. Methods The elderly PD patients who attended the Department of Neurology of Changshu Hospital of Traditional Chinese Medicine between November 2023 and March 2024 were selected. The patients’ frailty conditions were investigated using general information questionnaire, Chinese version of Tilburg Frailty Indicator, Hoehn-Yahr Rating Scale, Mini-Nutritional Assessment Short Form, Movement Disorder Society-Unified PD Rating Scale Part Ⅲ, PD Sleep Scale-2, and Mini-Mental State Examination. Multiple linear regression analysis was used to further determine the influencing factors of the frailty status in elderly PD patients. Results A total of 170 PD patients were included. Among them, 117 cases (68.82%) had frailty, while 53 cases (31.18%) had not frailty. The average score for frailty was (6.48±3.34) points, the average score for nutritional status was (11.89±1.65) points, the average score for motor function was (27.40±13.73) points, the average score for sleep quality was (16.05±7.76) points, and the average score for cognitive status is (26.25±4.51) points. The Pearson correlation analysis results showed that PD patient frailty was positively correlated with motor function and sleep quality (P<0.01), and negatively correlated with nutritional status and cognitive status (P<0.01). The results of multiple linear regression analysis showed that age, education, place of residence, course of disease, Hoehn-Yahr Rating, nutritional status, motor function, cognitive status and sleep quality were the influencing factors of frailty in PD patients (P<0.05). Conclusions Elderly PD patients are prone to frailty. Healthcare professionals should pay attention to early screening for frailty in this population and provide timely and effective interventions to prevent or delay the onset of frailty in patients.

Citation： CHEN Mengyuan, WANG Qiuqin, LIU Jie, ZHANG Xinyue, CHEN Juping, WANG Qunjuan, XU Guihua. Frailty status and its influencing factors in elderly Parkinson’s disease patients. West China Medical Journal, 2025, 40(5): 716-721. doi: 10.7507/1002-0179.202409024 Copy

1.	Costa HN, Esteves AR, Empadinhas N, et al. Parkinson’s disease: a multisystem disorder. Neurosci Bull, 2023, 39(1): 113-124.
2.	Thaler A, Alcalay RN. Diagnosis and medical management of Parkinson disease. Continuum (Minneap Minn), 2022, 28(5): 1281-1300 .
3.	程筱雨, 毛成洁, 刘春风. 帕金森病非运动症状的临床处理. 中国实用内科杂志, 2023, 43(10): 802-806.
4.	Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging, 2014, 9: 433-441.
5.	Tenison E, Henderson EJ. Multimorbidity and frailty: tackling complexity in Parkinson’s disease. J Parkinsons Dis, 2020, 10(s1): S85-S91.
6.	Borda MG, Pérez-Zepeda MU, Jaramillo-Jimenez A, et al. Frailty in Parkinson’s disease and its association with early dementia: a longitudinal study. Parkinsonism Relat Disord, 2022, 99: 51-57.
7.	Li J, Jin M, Wang L, et al. MDS clinical diagnostic criteria for Parkinson's disease in China. J Neurol, 2017, 264(3): 476-481.
8.	曾小敏, 彭扬琴, 杜蕾, 等. 医学统计学成绩影响因素的有序 Logistic 回归分析. 中国现代医学杂志, 2014, 24(29): 106-112.
9.	奚兴, 郭桂芳, 孙静. 中文版 Tilburg 衰弱评估量表的信效度研究. 护理学报, 2013, 20(16): 1-5.
10.	徐鲲, 董景敏, 张帅, 等. 不同 Hoehn-Yahr 分期帕金森病患者磁敏感加权成像下黑质小体-1 影像表现分析. 现代医用影像学, 2022, 31(3): 424-427.
11.	Rubenstein LZ, Harker JO, Salvà A, et al. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci, 2001, 56(6): M366-M372.
12.	Enge M, Peelen FO, Nielsen RL, et al. Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study. Eur J Nutr, 2024, 63(3): 927-938.
13.	曲艳, 李晓红, 孙亚南, 等. 汉化版 MDS-UPDRS 与传统 UPDRS 评测帕金森病的比较分析. 中国康复理论与实践, 2019, 25(8): 936-939.
14.	Liguori C, Frontani F, Francescangeli G, et al. Assessment of psychometric characteristics of Parkinson’s disease sleep scale 2 and analysis of a cut-off score for detecting insomnia in Italian patients with Parkinson’s disease: a validation study. J Pers Med, 2024, 14(3): 298.
15.	Chun CT, Seward K, Patterson A, et al. Evaluation of available cognitive tools used to measure mild cognitive decline: a scoping review. Nutrients, 2021, 13(11): 3974.
16.	Peball M, Mahlknecht P, Werkmann M, et al. Prevalence and associated factors of sarcopenia and frailty in Parkinson’s disease: a cross-sectional study. Gerontology, 2019, 65(3): 216-228.
17.	Dahodwala N, Li P, Jahnke J, et al. Burden of Parkinson's disease by severity: health care costs in the U. S. medicare population. Mov Disord, 2021, 36(1): 133-142.
18.	唐浪娟, 岳丽春, 刘聪香, 等. 帕金森病患者自我感受负担现状及其影响因素. 中国老年学杂志, 2020, 40(9): 1986-1989.
19.	马丹莹, 李莉, 王玮, 等. 主动脉弓置换术后患者 ICU 获得性衰弱现状及影响因素分析. 护理学报, 2021, 28(12): 38-42.
20.	Setiati S, Laksmi PW, Aryana I, et al. Frailty state among Indonesian elderly: prevalence, associated factors, and frailty state transition. BMC Geriatr, 2019, 19(1): 182.
21.	夏玮涛, 吴佳其, 阙家雯, 等. 浙江省城乡老年人衰弱比较. 护理学杂志, 2023, 38(12): 111-116.
22.	陈菲菲, 庞永慧, 茅乃权, 等. 老年肺癌患者衰弱现状及影响因素分析. 护理学报, 2020, 27(15): 7-11.
23.	孔含含, 张娇红, 曾剑锋, 等. 老年肺结核患者衰弱风险预测模型的构建及验证. 中国防痨杂志, 2024, 46(1): 85-91.
24.	Khan AU, Akram M, Daniyal M, et al. Awareness and current knowledge of Parkinson’s disease: a neurodegenerative disorder. Int J Neurosci, 2019, 129(1): 55-93.
25.	陈敏, 宋清扬, 李敏, 等. 老年帕金森患者心理健康危险因素 logistic 回归分析. 中华保健医学杂志, 2022, 24(6): 478-481.
26.	潘思颖, 朱玲, 汤淇云, 等. 帕金森病患者营养不良的影响因素分析及与衰弱、认知功能和跌倒风险的关系研究. 现代生物医学进展, 2023, 23(17): 3278-3282.
27.	王婵娟, 郝志敏, 熊三军, 等. 帕金森病患者的营养状况与病情严重程度的临床研究. 检验医学与临床, 2023, 20(2): 166-168, 173.
28.	Bianchi VE, Rizzi L, Somaa F. The role of nutrition on Parkinson’s disease: a systematic review. Nutr Neurosci, 2023, 26(7): 605-628.
29.	汪虹, 许方蕾, 汤爱玲, 等. 275 例早中期帕金森病患者社会参与现状及其相关因素分析. 中华全科医学, 2023, 21(11): 1907-1911.
30.	Tickle-Degnen L, Stevenson MT, Gunnery SD, et al. Profile of social self-management practices in daily life with Parkinson’s disease is associated with symptom severity and health quality of life. Disabil Rehabil, 2021, 43(22): 3212-3224.
31.	姚瑶, 樊才瑞, 孙晓萌, 等. 老年帕金森病患者睡眠障碍的危险因素及其对认知功能、心理状态和衰弱的影响. 现代生物医学进展, 2023, 23(19): 3669-3672, 3738.
32.	陈清燕, 姜林, 刘艳, 等. 帕金森病继发睡眠障碍患者抑郁症状和功能状态与衰弱的关系. 精神医学杂志, 2023, 36(4): 362-365.
33.	Lin WC, Huang YC, Leong CP, et al. Associations between cognitive functions and physical frailty in patients with Parkinson’s disease. Front Aging Neurosci, 2019, 11: 283.
34.	Sousa-Fraguas MC, Rodríguez-Fuentes G, Conejo NM. Frailty and cognitive impairment in Parkinson’s disease: a systematic review. Neurol Sci, 2022, 43(12): 6693-6706.
35.	Chen YS, Chen HL, Lu CH, et al. Reduced lateral occipital gray matter volume is associated with physical frailty and cognitive impairment in Parkinson’s disease. Eur Radiol, 2019, 29(5): 2659-2668.

1. Costa HN, Esteves AR, Empadinhas N, et al. Parkinson’s disease: a multisystem disorder. Neurosci Bull, 2023, 39(1): 113-124.
2. Thaler A, Alcalay RN. Diagnosis and medical management of Parkinson disease. Continuum (Minneap Minn), 2022, 28(5): 1281-1300 .
3. 程筱雨, 毛成洁, 刘春风. 帕金森病非运动症状的临床处理. 中国实用内科杂志, 2023, 43(10): 802-806.
4. Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging, 2014, 9: 433-441.
5. Tenison E, Henderson EJ. Multimorbidity and frailty: tackling complexity in Parkinson’s disease. J Parkinsons Dis, 2020, 10(s1): S85-S91.
6. Borda MG, Pérez-Zepeda MU, Jaramillo-Jimenez A, et al. Frailty in Parkinson’s disease and its association with early dementia: a longitudinal study. Parkinsonism Relat Disord, 2022, 99: 51-57.
7. Li J, Jin M, Wang L, et al. MDS clinical diagnostic criteria for Parkinson's disease in China. J Neurol, 2017, 264(3): 476-481.
8. 曾小敏, 彭扬琴, 杜蕾, 等. 医学统计学成绩影响因素的有序 Logistic 回归分析. 中国现代医学杂志, 2014, 24(29): 106-112.
9. 奚兴, 郭桂芳, 孙静. 中文版 Tilburg 衰弱评估量表的信效度研究. 护理学报, 2013, 20(16): 1-5.
10. 徐鲲, 董景敏, 张帅, 等. 不同 Hoehn-Yahr 分期帕金森病患者磁敏感加权成像下黑质小体-1 影像表现分析. 现代医用影像学, 2022, 31(3): 424-427.
11. Rubenstein LZ, Harker JO, Salvà A, et al. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci, 2001, 56(6): M366-M372.
12. Enge M, Peelen FO, Nielsen RL, et al. Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study. Eur J Nutr, 2024, 63(3): 927-938.
13. 曲艳, 李晓红, 孙亚南, 等. 汉化版 MDS-UPDRS 与传统 UPDRS 评测帕金森病的比较分析. 中国康复理论与实践, 2019, 25(8): 936-939.
14. Liguori C, Frontani F, Francescangeli G, et al. Assessment of psychometric characteristics of Parkinson’s disease sleep scale 2 and analysis of a cut-off score for detecting insomnia in Italian patients with Parkinson’s disease: a validation study. J Pers Med, 2024, 14(3): 298.
15. Chun CT, Seward K, Patterson A, et al. Evaluation of available cognitive tools used to measure mild cognitive decline: a scoping review. Nutrients, 2021, 13(11): 3974.
16. Peball M, Mahlknecht P, Werkmann M, et al. Prevalence and associated factors of sarcopenia and frailty in Parkinson’s disease: a cross-sectional study. Gerontology, 2019, 65(3): 216-228.
17. Dahodwala N, Li P, Jahnke J, et al. Burden of Parkinson's disease by severity: health care costs in the U. S. medicare population. Mov Disord, 2021, 36(1): 133-142.
18. 唐浪娟, 岳丽春, 刘聪香, 等. 帕金森病患者自我感受负担现状及其影响因素. 中国老年学杂志, 2020, 40(9): 1986-1989.
19. 马丹莹, 李莉, 王玮, 等. 主动脉弓置换术后患者 ICU 获得性衰弱现状及影响因素分析. 护理学报, 2021, 28(12): 38-42.
20. Setiati S, Laksmi PW, Aryana I, et al. Frailty state among Indonesian elderly: prevalence, associated factors, and frailty state transition. BMC Geriatr, 2019, 19(1): 182.
21. 夏玮涛, 吴佳其, 阙家雯, 等. 浙江省城乡老年人衰弱比较. 护理学杂志, 2023, 38(12): 111-116.
22. 陈菲菲, 庞永慧, 茅乃权, 等. 老年肺癌患者衰弱现状及影响因素分析. 护理学报, 2020, 27(15): 7-11.
23. 孔含含, 张娇红, 曾剑锋, 等. 老年肺结核患者衰弱风险预测模型的构建及验证. 中国防痨杂志, 2024, 46(1): 85-91.
24. Khan AU, Akram M, Daniyal M, et al. Awareness and current knowledge of Parkinson’s disease: a neurodegenerative disorder. Int J Neurosci, 2019, 129(1): 55-93.
25. 陈敏, 宋清扬, 李敏, 等. 老年帕金森患者心理健康危险因素 logistic 回归分析. 中华保健医学杂志, 2022, 24(6): 478-481.
26. 潘思颖, 朱玲, 汤淇云, 等. 帕金森病患者营养不良的影响因素分析及与衰弱、认知功能和跌倒风险的关系研究. 现代生物医学进展, 2023, 23(17): 3278-3282.
27. 王婵娟, 郝志敏, 熊三军, 等. 帕金森病患者的营养状况与病情严重程度的临床研究. 检验医学与临床, 2023, 20(2): 166-168, 173.
28. Bianchi VE, Rizzi L, Somaa F. The role of nutrition on Parkinson’s disease: a systematic review. Nutr Neurosci, 2023, 26(7): 605-628.
29. 汪虹, 许方蕾, 汤爱玲, 等. 275 例早中期帕金森病患者社会参与现状及其相关因素分析. 中华全科医学, 2023, 21(11): 1907-1911.
30. Tickle-Degnen L, Stevenson MT, Gunnery SD, et al. Profile of social self-management practices in daily life with Parkinson’s disease is associated with symptom severity and health quality of life. Disabil Rehabil, 2021, 43(22): 3212-3224.
31. 姚瑶, 樊才瑞, 孙晓萌, 等. 老年帕金森病患者睡眠障碍的危险因素及其对认知功能、心理状态和衰弱的影响. 现代生物医学进展, 2023, 23(19): 3669-3672, 3738.
32. 陈清燕, 姜林, 刘艳, 等. 帕金森病继发睡眠障碍患者抑郁症状和功能状态与衰弱的关系. 精神医学杂志, 2023, 36(4): 362-365.
33. Lin WC, Huang YC, Leong CP, et al. Associations between cognitive functions and physical frailty in patients with Parkinson’s disease. Front Aging Neurosci, 2019, 11: 283.
34. Sousa-Fraguas MC, Rodríguez-Fuentes G, Conejo NM. Frailty and cognitive impairment in Parkinson’s disease: a systematic review. Neurol Sci, 2022, 43(12): 6693-6706.
35. Chen YS, Chen HL, Lu CH, et al. Reduced lateral occipital gray matter volume is associated with physical frailty and cognitive impairment in Parkinson’s disease. Eur Radiol, 2019, 29(5): 2659-2668.

West China Medical Journal

Frailty status and its influencing factors in elderly Parkinson’s disease patients

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