Females with Parkinson's disease (PD) are vulnerable to frailty. PD eventually leads to decreased physical activity, an indicator of frailty. We speculate PD results in frailty through reduced physical activity. Objective. Determine the contribution of physical activity on frailty in PD (n = 15, 65 ± 9 years) and non-PD (n = 15, 73 ± 14 years) females. Methods. Frailty phenotype (nonfrail/prefrail/frail) was categorized and 8 hours of physical activity was measured using accelerometer, global positioning system, and self-report. Two-way ANCOVA (age as covariate) was used to compare physical activity between disease and frailty phenotypes. Spearman correlation assessed relationships, and linear regression determined associations with frailty. Results. Nonfrail recorded more physical activity (intensity, counts, self-report) compared with frail. Self-reported physical activity was greater in PD than non-PD. In non-PD, step counts, light physical activity time, sedentary time, and self-reported physical activity were related to frailty (R = 0.91). In PD, only carbidopa-levodopa dose was related to frailty (r = 0.61). Conclusion. Physical activity influences frailty in females without PD. In PD females, disease management may be a better indicator of frailty than physical activity. Further investigation into how PD associated factors contribute to frailty is warranted.
Muscle strength is sex-related and declines with advancing age yet, a comprehensive comparative evaluation of age-related strength loss in human females and males has not been undertaken. To do so, segmented piecewise regression analysis was performed on aggregated data from studies published 1990-2018 and available in CINAHL, EMBASE, MEDLINE, and PsycINFO databases. The search identified 5613 articles which were reviewed for physical assessment results stratified by sex and age. Maximal isometric and isokinetic 60°s-1 contractions of the KE and KF from 57 studies and 15,283 subject (N=7918 females) had sufficient data reported on females and males for meaningful statistical evaluation to be undertaken. The analysis revealed that isometric KE and KF strength undergo similar rapid declines in both sexes late in the 6th decade of life. Yet, there is an abrupt age-related decline in KE 60°s-1 peak torque earlier in females (41.8 years) than males (66.7 years). In the assessment of KF peak torque, an age-related acceleration in strength loss was only identified in males (49.3 years). The results suggest that age-related isometric strength loss is similar between sexes while the characteristics of KE and KF peak torque decline are sex-related which likely explains the differential rate of age-related functional decline. Novelty • Inclusion of muscle strength and torque of KE and KF data from >15 000 subjects • Isometric KE and KF strength loss are similar between sexes • Isokinetic 60°s-1 KE torque decline accelerates 25 years earlier in females and female age-related KF peak torque decline does not accelerate with age
Background: Females with Parkinson’s disease (PD) are at greater risk of frailty than males. Little is known about how age and disease-related characteristics influence frailty in females with PD because frailty studies often exclude persons with underlying neurological pathologies. Objective: To determine age and diseaserelated characteristics that best explain physical frailty in community-dwelling females with and without PD. Design & Measurement: Correlation coefficients described relationships between PD-related characteristics and physical frailty phenotype criteria (Cardiovascular Health Study). Regression analysis identified associations between disease-related characteristics and frailty in non-PD and PD females. Setting: Community-dwelling. Participants: Females with mild to moderate PD (n = 17, mean age = 66 ± 8.5 years) and non-PD (n = 18, mean age = 72 ± 13.2 years) participated. Results: Daily carbidopa-levodopa dose best explained frailty in PD females (β = 0.5), whereas in non-PD females, age (β = 0.7) and comorbidity (β = 0.5) were most associated with frailty. Conclusions: Dopaminergic medication explained frailty in PD and not measures of disease progression (i.e. severity, duration). In females without PD age-related accumulation of comorbidities resulted in greater risk of frailty. This indicates dopaminergic management of PD symptoms may better reflect frailty in females with PD than disease severity or duration. These data suggest the influence of underlying frailty should be considered when managing neurological conditions. Understanding how frailty concurrently exists with PD and how these conditions progress within the aging female will facilitate future care management.
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