帕金森病患者的身体构成、跌倒和步态冻结:性别效应

IF 3.3 Q2 GERIATRICS & GERONTOLOGY
C Pongmala, C Stonsaovapak, M van Emde Boas, H Bhanderi, A Luker, F Michalakis, P Kanel, R L Albin, J M Haus, N I Bohnen
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引用次数: 0

摘要

背景:姿势不稳和步态困难(PIGD)是帕金森病(PD)患者丧失活动能力和生活质量下降的一个重要原因。当帕金森病发展到一定程度时,患者可能会出现跌倒和步态冻结(FoG),从而导致患者害怕跌倒并越来越喜欢久坐。久坐会导致肌肉疏松症,并引起身体成分的其他变化,尤其是年老体弱的患者。以往的研究表明,随着年龄的增长,不同性别的身体成分会发生不同的变化,而且在帕金森氏症的症状和进展方面也存在性别差异,但不同性别的身体成分与帕金森氏症症状(如FoG和跌倒)之间的关系仍未得到探讨:方法:136 名 PD 受试者接受了详细的临床测试,并使用双能 X 射线吸收测量法(DXA)评估了全身成分。结果:多变量逻辑正向逐步回归分析显示,身体成分与FoG和跌倒有关:多变量回归分析显示,在患有帕金森氏症的男性患者中,较低的腿部瘦体重与FoG的存在显著相关(OR,0.429;95% CI,0.219-0.839;p=0.013),但与跌倒无关。在患有帕金森病的女性患者中,较高的腿部脂肪量与跌倒显著相关(OR,4.780;95% CI,1.506-15.174;p=0.008),但与FoG无关:这些观察结果表明,在帕金森病患者中,身体成分和FoG与跌倒之间存在着性别特异性关联。未来的研究应特别关注性别差异,探索干预措施对帕金森病患者身体成分的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Body Composition, Falls, and Freezing of Gait in Parkinson's Disease: Gender-Specific Effects.

Background: Postural instability and gait difficulties (PIGD) are a significant cause of mobility loss and lower quality of life in Parkinson's disease (PD). When PD progresses, patients may experience falls and freezing of gait (FoG) resulting in fear of falling and increasing sedentariness. Sedentary behavior results in sarcopenia associated with other changes in body composition, especially in older patients becoming frail. Previous studies have shown gender-specific changes in body composition with aging as well as gender disparities in symptoms and progression of PD, yet the association between gender-specific body composition and PIGD symptoms such as FoG along with falls, remains unexplored.

Obective: This study aimed to investigate the association between gender-specific changes in body composition, FoG and falls assessment.

Methods: 136 PD subjects underwent detailed clinical test batteries and had whole-body composition assessed using dual-energy X-ray absorptiometry (DXA). Multivariate logistic forward stepwise regression was performed to define body composition associations for FoG and falls.

Results: Multivariate regression analysis revealed that in males with PD, lower leg lean mass was significantly associated with the presence of FoG (OR, 0.429; 95% CI, 0.219-0.839; p=0.013) but not with falls. In females with PD, higher leg adipose mass was significantly associated with falls (OR, 4.780; 95% CI, 1.506-15.174; p=0.008) but not with FoG.

Conclusion: These observations suggest gender specific associations between body composition and FoG vs. falls in PD. Future research should explore the impact of interventions on body composition in individuals with PD by paying specific attention to gender differences.

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来源期刊
Journal of Frailty & Aging
Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-
CiteScore
5.90
自引率
7.70%
发文量
54
期刊介绍: The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons.          The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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