Factors associated with frailty syndrome in elderly people with Parkinson’s disease

Couto, Alcimar Marcelo do; Soares, Sonia Maria

doi:10.1590/0034-7167-2022-0096

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Sumário

ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (suppl 4) • 2022 • https://doi.org/10.1590/0034-7167-2022-0096 copy

Factors associated with frailty syndrome in elderly people with Parkinson’s disease

Factores relacionados a la síndrome de fragilidad en ancianos con enfermedad de Parkinson

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to analyze the sociodemographic and clinical factors associated with frailty in the elderly with Parkinson’s disease in the context of a Specialized Health Care Service for the Elderly.

Methods:

documentary, analytical, correlational, cross-sectional study carried out with 230 elderly people with Parkinson’s. The medical records of the patients were evaluated with a focus on two instruments: Clinical-Functional Vulnerability Index - 20; and the Multidimensional Assessment Care Plan.

Results:

predominance of elderly people between 80 and 89 years old; women; with low education; classified as fragile. There was a correlation between frailty and the variables: sex; age; age group; schooling; motor manifestations; non-motor manifestations; Hoehn and Yahr staging and time to diagnosis.

Conclusions:

high simultaneity of frailty conditions and Parkinson’s disease was observed. It is believed that the results will be able to help the structuring of protocols for nursing performance in a systematic way in the promotion of self-care of these individuals.

Descriptors:
Parkinson Disease; Aged; Health Vulnerability; Frailty; Nursing.

IVCF-20 Score	Median 20	(Q1 - Q3)^* * Q1 - Q3: first quartile - third quartile. (14 - 26)
IVCF-20 Score	n	%
Clinical-functional classification
Robust Risk of frailty Frail	19 40 171	8.3 17.4 74.3
Total	230	100.0

Clinical-functional variables/classification	Frailty						p value^* * Chi-square test;
	Not frail (n = 59)		Frail (n = 171)		Total (n = 230)
	n	%	n	%	n	%
Age group
60 to 69 years	16	27.1	17	9.9	33	14.3	0.003^* ***** significant p value.
70 to 79 years	22	37.3	54	31.6	76	33.0
80 to 89 years	18	30.5	84	49.1	102	44.3
90 years or older	3	5.1	16	9.4	19	8.4
Median age (Q1 - Q3)^ Mann-Whitney test;	76 (68 - 82)		81 (75 - 86)		80 (73 - 85)		0.000^* ***** significant p value.
Sex
Male	34	57.6	72	42.1	106	46.1	0.039^* ***** significant p value.
Female	25	42.4	99	57.9	124	53.9	0.039^* ***** significant p value.
Educational level
Did not study	2	3.5	45	26.3	47	20.4	0.007^* ***** significant p value.
1 to 4 years	42	70.1	92	53.9	134	58.2
5 to 8 years	5	8.8	14	8.4	19	8.3
9 to 11 years	8	14	14	8.4	22	9.6
more than 11 years	2	3.5	6	3	8	3.5

Clinical-functional variables/classification	Frailty						p value^* * Chi-square test;
	Not frail		Frail		Total
	n	%	n	%	n	%
Motor Manifestations
Tremors	41	87.2%	99	71.7%	140	75.7%	0.032^* ***** significant p value.
Stiffness	25	53.2%	107	77.5%	132	71.4%	0.001^* ***** significant p value.
Bradykinesia	34	72.3%	101	73.2%	135	73.0%	0.910
Freezing (freezing)	1	1.9%	16	10.5%	17	8.3%	0.054
Postural Instability	33	55.9%	134	78.4%	167	72.6%	0.001^* ***** significant p value.
Speech/conversation	11	18.6%	60	35.1%	71	30.9%	0.018^* ***** significant p value.
Excess of salivation	2	3.4%	14	8.2%	16	7.0%	0.212
Chewing/swallowing	6	10.2%	59	34.5%	65	28.3%	0.000^* ***** significant p value.
Writing (micrograph)	1	1.7%	2	1.2%	3	1.3%	0.759
Non-Motor Manifestations
Cognitive Disorder	11	18.6%	104	60.8%	115	50.0%	0.000^* ***** significant p value.
Mood Disorder/Depression	31	52.5%	128	74.9%	159	69.1%	0.001^* ***** significant p value.
Hallucinations and delusions	3	5.1%	41	24.0%	44	19.1%	0.001^* ***** significant p value.
Anxiety	14	23.7%	31	18.1%	45	19.6%	0.350
Apathy	2	3.4%	28	16.4%	30	13.0%	0.011^* ***** significant p value.
Fatigue	3	5.1%	15	8.8%	18	7.8%	0.363
Sleep disorder	28	50.9%	99	61.5%	127	58.8%	0.169
Urinary disorder	29	49.2%	132	77.2%	161	70.0%	0.000^* ***** significant p value.
Postural hypotension	11	18.6%	27	15.8%	38	16.5%	0.611
Cold	18	30.5%	72	42.1%	90	39.1%	0.116
Pain	11	18.6%	46	26.9%	57	24.8%	0.205

Clinical-functional variables/classification	Frailty						p value^* * Chi-square test;
	Not frail		Frail		Total
	n	%	n	%	n	%
Staging
Light	29	50.0%	16	9.5%	45	19.8%	0.000^* ***** significant p value.
Moderate	25	43.1%	62	36.7%	87	38.3%
Serious	4	6.9%	91	53.8%	95	41.9%
Diagnosis time
Median (Q1 - Q3)^ Mann Whitney test;	2 (0 - 6.5)		4 (1 - 9)		4 (0 - 8)		0.034^* ***** significant p value.
Makes use of prolopa
No	1	1.9%	8	5.1%	9	4.2%	0.312
Yes	53	98.1%	150	94.9%	203	95.8%
Take another medication antiparkinsonian
No	44	81.5%	125	79.1%	169	79.7%	0.709
Yes	10	18.5%	33	20.9%	43	20.3%	0.709
Type of other Antiparkinsonian’s medication
Pramipexol	5	50.0%	16	48.5%	21	48.8%	0.693
Entacapone	2	20.0%	10	30.3%	12	27.9%
Amantadina	2	20.0%	2	6.1%	4	9.3%
Pramipexol + entacapone	1	10.0%	4	12.1%	5	11.6%
Pramipexol + amantadina	0	0.0%	1	3.0%	1	2.3%

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[1] Corresponding author: Alcimar Marcelo do Couto E-mail: amarcelocouto@gmail.com