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, 毛成潔, 劉春風. 帕金森病非運動癥狀的臨床處理. 中國實用內科雜志, 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, 彭揚琴, 杜蕾, 等. 醫學統計學成績影響因素的有序 Logistic 回歸分析. 中國現代醫學雜志, 2014, 24(29): 106-112.
9.	奚興, 郭桂芳, 孫靜. 中文版 Tilburg 衰弱評估量表的信效度研究. 護理學報, 2013, 20(16): 1-5.
10.	徐鯤, 董景敏, 張帥, 等. 不同 Hoehn-Yahr 分期帕金森病患者磁敏感加權成像下黑質小體-1 影像表現分析. 現代醫用影像學, 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.	曲艷, 李曉紅, 孫亞南, 等. 漢化版 MDS-UPDRS 與傳統 UPDRS 評測帕金森病的比較分析. 中國康復理論與實踐, 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, 岳麗春, 劉聰香, 等. 帕金森病患者自我感受負擔現狀及其影響因素. 中國老年學雜志, 2020, 40(9): 1986-1989.
19.	馬丹瑩, 李莉, 王瑋, 等. 主動脈弓置換術后患者 ICU 獲得性衰弱現狀及影響因素分析. 護理學報, 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.	夏瑋濤, 吳佳其, 闕家雯, 等. 浙江省城鄉老年人衰弱比較. 護理學雜志, 2023, 38(12): 111-116.
22.	陳菲菲, 龐永慧, 茅乃權, 等. 老年肺癌患者衰弱現狀及影響因素分析. 護理學報, 2020, 27(15): 7-11.
23.	孔含含, 張嬌紅, 曾劍鋒, 等. 老年肺結核患者衰弱風險預測模型的構建及驗證. 中國防癆雜志, 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.	陳敏, 宋清揚, 李敏, 等. 老年帕金森患者心理健康危險因素 logistic 回歸分析. 中華保健醫學雜志, 2022, 24(6): 478-481.
26.	潘思穎, 朱玲, 湯淇云, 等. 帕金森病患者營養不良的影響因素分析及與衰弱、認知功能和跌倒風險的關系研究. 現代生物醫學進展, 2023, 23(17): 3278-3282.
27.	王嬋娟, 郝志敏, 熊三軍, 等. 帕金森病患者的營養狀況與病情嚴重程度的臨床研究. 檢驗醫學與臨床, 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, 許方蕾, 湯愛玲, 等. 275 例早中期帕金森病患者社會參與現狀及其相關因素分析. 中華全科醫學, 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.	姚瑤, 樊才瑞, 孫曉萌, 等. 老年帕金森病患者睡眠障礙的危險因素及其對認知功能、心理狀態和衰弱的影響. 現代生物醫學進展, 2023, 23(19): 3669-3672, 3738.
32.	陳清燕, 姜林, 劉艷, 等. 帕金森病繼發睡眠障礙患者抑郁癥狀和功能狀態與衰弱的關系. 精神醫學雜志, 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, 毛成潔, 劉春風. 帕金森病非運動癥狀的臨床處理. 中國實用內科雜志, 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, 彭揚琴, 杜蕾, 等. 醫學統計學成績影響因素的有序 Logistic 回歸分析. 中國現代醫學雜志, 2014, 24(29): 106-112.
9. 奚興, 郭桂芳, 孫靜. 中文版 Tilburg 衰弱評估量表的信效度研究. 護理學報, 2013, 20(16): 1-5.
10. 徐鯤, 董景敏, 張帥, 等. 不同 Hoehn-Yahr 分期帕金森病患者磁敏感加權成像下黑質小體-1 影像表現分析. 現代醫用影像學, 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. 曲艷, 李曉紅, 孫亞南, 等. 漢化版 MDS-UPDRS 與傳統 UPDRS 評測帕金森病的比較分析. 中國康復理論與實踐, 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, 岳麗春, 劉聰香, 等. 帕金森病患者自我感受負擔現狀及其影響因素. 中國老年學雜志, 2020, 40(9): 1986-1989.
19. 馬丹瑩, 李莉, 王瑋, 等. 主動脈弓置換術后患者 ICU 獲得性衰弱現狀及影響因素分析. 護理學報, 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. 夏瑋濤, 吳佳其, 闕家雯, 等. 浙江省城鄉老年人衰弱比較. 護理學雜志, 2023, 38(12): 111-116.
22. 陳菲菲, 龐永慧, 茅乃權, 等. 老年肺癌患者衰弱現狀及影響因素分析. 護理學報, 2020, 27(15): 7-11.
23. 孔含含, 張嬌紅, 曾劍鋒, 等. 老年肺結核患者衰弱風險預測模型的構建及驗證. 中國防癆雜志, 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. 陳敏, 宋清揚, 李敏, 等. 老年帕金森患者心理健康危險因素 logistic 回歸分析. 中華保健醫學雜志, 2022, 24(6): 478-481.
26. 潘思穎, 朱玲, 湯淇云, 等. 帕金森病患者營養不良的影響因素分析及與衰弱、認知功能和跌倒風險的關系研究. 現代生物醫學進展, 2023, 23(17): 3278-3282.
27. 王嬋娟, 郝志敏, 熊三軍, 等. 帕金森病患者的營養狀況與病情嚴重程度的臨床研究. 檢驗醫學與臨床, 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, 許方蕾, 湯愛玲, 等. 275 例早中期帕金森病患者社會參與現狀及其相關因素分析. 中華全科醫學, 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. 姚瑤, 樊才瑞, 孫曉萌, 等. 老年帕金森病患者睡眠障礙的危險因素及其對認知功能、心理狀態和衰弱的影響. 現代生物醫學進展, 2023, 23(19): 3669-3672, 3738.
32. 陳清燕, 姜林, 劉艷, 等. 帕金森病繼發睡眠障礙患者抑郁癥狀和功能狀態與衰弱的關系. 精神醫學雜志, 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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