Investigação de testes de sarcopenia como preditores de quedas na doença de Parkinson leve a moderada: estudo de coorte prospectivo

Abstract

Parkinson's Disease (PD) is the second most prevalent neurodegenerative disease in Brazil, affecting 1% of the elderly population aged over 65 years and 4 to 5% of those aged over 85 years. It is a chronic and progressive central nervous system disorder associated with a decreased quality of life and functional impairment. The prevalence of falls in elderly individuals with PD is higher than in the general population, with an annual risk of falls ranging from 45% to 68%. It is known that there are differences between single fallers and recurrent fallers, but there are limited studies addressing this context. Sarcopenia is a complex and multifactorial condition characterized by a progressive and generalized reduction in the quantity and quality of skeletal muscle tissue. Currently considered a global public health issue, sarcopenia is associated with an increased risk of falls, fractures, functional impairment, and mortality in the elderly. The objective of this study was to investigate predictive factors for recurrent and non-recurrent falls based on the diagnostic criteria of sarcopenia in patients with mild to moderate Parkinson's Disease. This was a cohort study conducted at the Hospital Universitário Walter Cantidio in Fortaleza, Ceará, with patients from the Movement Disorders outpatient clinic of the Neurology department from March 2021 to March 2023. To be eligible, patients needed to have a confirmed diagnosis of PD, a Hoehn and Yahr severity stage between 1 and 3, and the ability to stand and walk independently. Individuals with severe medical problems or uncontrolled chronic diseases were excluded. Demographic and clinical data, anthropometric measurements, cognitive assessment using the Mini-Mental State Examination, evaluation of depressive symptoms using the Geriatric Depression Scale, assessment of parkinsonian symptoms using the Unified Parkinson's Disease Rating Scale, fall history, and sarcopenia assessment based on the Revised European Consensus on Sarcopenia recommendations were collected during the patients' regular appointments. Each patient received a questionnaire to fill out in case of falls during the 12-month period. Monthly phone calls were made to check for fall occurrences. The study sample consisted of 103 patients, of whom 38 (37%) were women and 65 (63%) were men, with an average age of 66 ± 10.5 years. Higher SARC-F scores and a longer disease duration were independent predictors of recurrent and non-recurrent falls over a 12-month period.