Determinantes de sarcopenia e fragilidade em pessoas com Parkinson no contexto amazônico

Abstract

Introduction: Aging is a natural process characterized by the progressive loss of tissue and organ function, increasing the predisposition to various diseases, including Parkinson's Disease (PD). Among the conditions associated with PD, sarcopenia and frailty stand out as relevant geriatric syndromes. Sarcopenia is defined by the progressive reduction of muscle mass, strength, and function, while frailty is characterized by greater vulnerability to stressors, impacting physiological reserve and functional capacity. Despite distinct concepts, both share pathophysiological mechanisms affecting muscle power, such as chronic inflammation, oxidative stress, and neuromuscular degeneration. The absence of accessible and standardized instruments for screening these geriatric syndromes in clinical settings represents a challenge, especially considering the applicability of these methods in different sociodemographic contexts, such as in the Amazon region. Objective: This study aimed to analyze the profile of sarcopenia and frailty, as well as possible associations with clinical parameters of PD and sociodemographic aspects in people with Parkinson's disease (PwP) living in the community of a state in the Amazon region. Methods: This is an observational and analytical study, including PwP over 40 years of age, of both sexes. Initially, an anamnesis was conducted to collect sociodemographic data, followed by using instruments such as SARC-Calf and Short Physical Performance Battery (SPPB) for sarcopenia screening, and Fried's Phenotype for frailty screening. Vertical power was analyzed using the My Jump 2 app, considering parameters such as jump height, flight time, take-off velocity, force, and power. For statistical analysis, Spearman's correlation coefficient was used to identify possible associations between sarcopenia and frailty with clinical and sociodemographic variables. Subsequently, logistic regression was conducted to assess whether body mass predicted sarcopenia. Regarding frailty, none of the predictors were significant. All analyses were performed using SPSS software (IBM, Greenville, SC), version 25.0. Results: A total of 24 people with Parkinson's disease (PwP) were evaluated, 83.3% of whom were male, with a mean age of 66.35 years, living with a spouse and children (37.5%). They were stratified into sarcopenic (29.2%) and non- sarcopenic (70.8%) groups. An association was observed between sarcopenia and body mass (OR = 1.438; CI = 1.045 – 1.980). Regarding frailty, the prevalence was lower than reported in the literature, possibly due to the small sample size. Conclusion: This study concluded that body mass was a risk predictor for sarcopenia in PwP, and that the sample profile was predominantly male, with a higher occurrence of falls in stage 2 of PD and a high prevalence of pre-frailty. Despite the absence of other significant predictors for sarcopenia and frailty, the findings highlight the need for clinical standardization and universal diagnostic criteria, considering regional sociodemographic aspects.