Associations Between Cognitive Functions and Physical Frailty in Patients With Parkinson’s Disease

Lin, Wei-Che; Huang, Yu‐Chi; Leong, Chau-Peng; Chen, Meng‐Hsiang; Chen, Hsiu-Ling; Tsai, Nai‐Wen; Tso, Hui-Hsin; Chen, Po‐Cheng; Lu, Cheng-Hsien

doi:10.3389/fnagi.2019.00283

Cited by 11 publications

(24 citation statements)

References 41 publications

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“…The Mini-Mental State Examination (MMSE) was used to assess cognitive function in patients with idiopathic PD. Additionally, the subtests from the Cognitive Ability Screening Instrument (CASI) [ 35 ] and the Wechsler Adult Intelligence Scale-III (WAIS-III) [ 36 ] were used to build a neuropsychological battery including five domains (attention, executive function, language, memory, and visuospatial function) [ 37 ]. A neuropsychological battery was performed by a clinical psychologist blinded to each patient’s status.…”

Section: Methodsmentioning

confidence: 99%

Systemic oxidative stress and cognitive function in Parkinson’s disease with different PWMH or DWMH lesions

et al. 2021

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Background Parkinson’s disease (PD), frequently accompanied by cognitive impairments, is associated with systemic oxidative stress and abnormal structural changes on brain images. We aimed to identify the correlation between systemic oxidative stress and cognitive function in PD patients with different periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). Methods A total of 146 participants with idiopathic PD underwent brain MRI, which revealed PWMH and DWMH. The number of lesions were evaluated using the Fazekas criteria. Systemic oxidative stress was determined as early or late phase changes in leukocyte apoptosis and its subsets by flow cytometry. Cognitive functions, including attention, executive function, memory, language, and visual space, were assessed. Results For different DWMH, the leukocyte apoptosis and its subsets were significantly different.. However, there were no significant differences in oxidative stress biomarkers in PD patients with different PWMH. Attention and memory were significantly decreased in patients with more advanced DWMH injuries. Attention, memory, and language were significantly impaired in patients with worse PWMH lesions. Conclusion Significant oxidative stress biomarker alternations in PD patients with DWMH, but not PWMH, might be associated with white matter injury. Systemic inflammatory responses may contribute to deep white matter damage in PD. Further, more cognitive deficits were seen in PD patients with worse deep white matter lesions, especially in moderate to severe periventricular white matter injury. Trial registration Retrospective study.

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Section: Methodsmentioning

confidence: 99%

Systemic oxidative stress and cognitive function in Parkinson’s disease with different PWMH or DWMH lesions

et al. 2021

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“…Four out of the five selected studies assessed frailty through the biomedical paradigm. In particular, three of those (Shimada et al, 2013;Chen et al, 2019;Lin et al, 2019) adopted Fried's criteria, while one (Dutzi et al, 2017) used the model proposed by Rockwood et al (2005) and Rockwood and Mitnitski (2007b). Shimada et al (2013) analyzed the relationship between physical frailty and Mild Cognitive Impairment (MCI) in 5104 community-dwelling persons aged 65 years and older (mean age 71 years).…”

Section: Description Of the Selected Studiesmentioning

confidence: 99%

“…The other two selected studies adopting the phenotypic model analyzed the relationship between physical frailty and cognitive impairment in patients with PD (Chen et al, 2019;Lin et al, 2019). Chen et al (2019) investigated structural brain changes in relation to physical frailty and cognitive decline in sixty-one PD patients (mean age 62.61 ± 8.59 years), by using MRI.…”

Section: Description Of the Selected Studiesmentioning

confidence: 99%

“…In light of these results, the authors suggested that assessing cognitive functions in PD patients might be a useful approach to identify the subjects at greatest risk of developing frailty and to prevent negative outcomes through targeted strategies of intervention (Lin et al, 2019). Dutzi et al (2017) assessed frailty by using the model proposed by Rockwood et al (2005).…”

Section: Description Of the Selected Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Possible Association Between Executive Dysfunction and Frailty in Patients With Neurocognitive Disorders

et al. 2020

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Frailty is an age-related dynamic status, characterized by a reduced resistance to stressors due to the cumulative decline of multiple physiological systems. Several researches have highlighted a relationship between physical frailty and cognitive decline; however, the role of specific cognitive domains has not been deeply clarified yet. Current studies have hypothesized that physical frailty and neuropsychological deficits may share systemic inflammation and increased oxidative stress in different neurodegenerative disorders, such as Alzheimer’s and Parkinson’s disease. However, the role of the executive dysfunction should be investigated in a more detailed way using a multidimensional approach. With this aim, we conducted a review of the literature on the few experimental articles published to discuss the existence of a relationship between frailty and cognitive impairment in neurocognitive disorders, particularly focusing on the domain of executive dysfunction. The data suggest that physical frailty and cognitive decline, especially executive dysfunction, are two aspects strongly linked in mild and major neurocognitive disorders due to Alzheimer’s and Parkinson’s disease. In light of this, a new framework linking aging, cognitive decline, and neurodegenerative diseases is needed. In order to analyze the effects that aging processes have on neural decline and neurocognitive disease, and to identify relevant groups of users and patients, future longitudinal studies should adopt a multidimensional approach, in the field of primary prevention and in the continuum from mild to major neurocognitive disorder.

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Physical Frailty, Genetic Predisposition, and Incident Parkinson Disease

Zhang

Rong

et al. 2023

JAMA Neurol

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ImportanceCross-sectional evidence implicates high prevalent frailty in patients with Parkinson disease (PD), whereas the longitudinal association remains unknown.ObjectivesTo examine the longitudinal association of the frailty phenotype with the development of PD and to explore the modification role of genetic risk of PD in such an association.Design, Setting, and ParticipantsThis prospective cohort study launched in 2006 to 2010 with a follow-up of 12 years. Data were analyzed from March 2022 to December 2022. The UK Biobank recruited over 500 000 middle-aged and older adults from 22 assessment centers across the United Kingdom. Participants who were younger than 40 years (n = 101), diagnosed with dementia or PD at baseline, and developed dementia, PD, or died within 2 years from baseline were excluded (n = 4050). Participants who had no genetic data or mismatch between genetic sex and reported gender (n = 15 350), were not of self-reported British White descent (n = 27 850), and had no data for frailty assessment (n = 100 450) or any covariates were also excluded (n = 39 706). The final analysis included 314 998 participants.ExposuresThe physical frailty was assessed by the Fried criteria’s frailty phenotype through 5 domains, ie, weight loss, exhaustion, low physical activity, slow walking speed, and low grip strength. The polygenic risk score (PRS) for PD comprised 44 single-nucleotide variants.Main Outcomes and MeasuresNew-onset PD was identified through the hospital admission electronic health records and death register.ResultsAmong 314 998 participants (mean age, 56.1 years; 49.1% male), 1916 new-onset PD cases were documented. Compared with nonfrailty, the hazard ratio (HR) of incident PD in prefrailty and frailty was 1.26 (95% CI, 1.15-1.39) and 1.87 (95% CI, 1.53-2.28), respectively, and the absolute rate difference per 100 000 person-years was 1.6 (95% CI, 1.0-2.3) for prefrailty and 5.1 (95% CI, 2.9-7.3) for frailty. Exhaustion (HR, 1.41; 95% CI, 1.22-1.62), slow gait speed (HR, 1.32; 95% CI, 1.13-1.54), low grip strength (HR, 1.27; 95% CI, 1.13-1.43), and low physical activity (HR, 1.12; 95% CI, 1.00-1.25) were associated with incident PD. A significant interaction between frailty and PRS on PD was found and the highest hazard was observed in participants with frailty and high genetic risk.Conclusions and RelevancePhysical prefrailty and frailty were associated with incident PD independent of sociodemographic factors, lifestyles, multiple morbidities, and genetic background. These findings may have implications for the assessment and management of frailty for PD prevention.

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Associations Between Cognitive Functions and Physical Frailty in Patients With Parkinson’s Disease

Cited by 11 publications

References 41 publications

Systemic oxidative stress and cognitive function in Parkinson’s disease with different PWMH or DWMH lesions

Systemic oxidative stress and cognitive function in Parkinson’s disease with different PWMH or DWMH lesions

A Possible Association Between Executive Dysfunction and Frailty in Patients With Neurocognitive Disorders

Physical Frailty, Genetic Predisposition, and Incident Parkinson Disease

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