Associated Factors Of Sarcopenia And Fall Risk In Early And Middle Stages Of Patients With Parkinson’s Disease

Objective:In this study,we collected and evaluated the prevalence of sarcopenia and fall risk in hospitalized patients with Parkinson ’s disease(PD)in early and middle stage.We explored the relationship between sarcopenia and fall risk with general data and clinical data,and analyzed the risk factors of sarcopenia and fall risk.It is expected to help patients with Parkinson ’s disease complicated with sarcopenia and falls to diagnose and intervene as soon as possible,provide a basis for later nutritional intervention and exercise training,thereby improving the prognosis and the quality of life of patients with PD,and provide theoretical and data basis for related clinical research.Methods:This study collected 137 patients with early and middle stage primary Parkinson’s disease diagnosed in the Department of Neurology,the First Hospital of Shanxi Medical University from April 2021 to February 2023 as the research object.Those patients with PD were divided into sarcopenia group and non-sarcopenia group by using the diagnostic cut-off value of the consensus on diagnosis issued by the Asian Work ing Group on Sarcopenia(AWGS)in 2019.According to the score of Morse fall risk assessment scale,the above subjects were divided into low risk group,middle risk group and high risk group.The general data of the above subjects were collected,including gender,age and occupation.The height and bilateral calf circumference of the patients were measured,and the body composition analyzer was used to measure the body measurement indexes such as protein content,body fat rate,body mass index,basal metabolic rate and skeletal muscle mass of the whole body and specific areas.Grip strength was measured by hand-held dynamometer.And use a stopwatch to measure the pace.The blood biochemical indexes such as serum uric acid,albumin,thyroid function,homocyst eine,folic acid and vitamin B12 were collected.Clinical data such as disease duration,diabetes duration,clinical subtype,UPDRS-III score,modified Hoehn-Yahr grading score,levodopa daily equivalent dose(LEDD),motor complications,orthostatic hypoten sion,MMSE score,MOCA score,ADL score,HAMA score,HAMD score and SARC-Cal F scale were collected.Firstly,univariate analysis was used to compare the effects of various factors on sarcopenia and fall risk.Secondly,binary logistic regression analysis and multivariate ordered logistic regression analysis were used to analyze the related factors of sarcopenia and fall risk.Results:1.A total of 137 patients with Parkinson ’s disease were included in this study,including 67 males and 70 females.There wer e 13 patients with sarcopenia and 124 patients without sarcopenia.The prevalence of sarcopenia in PD patients was 9.49 %.The results of single factor analysis showed that BMI,pace,grip strength,protein content,skeletal muscle mass,body fat rate,bas al metabolic rate and H-Y grade were statistically different(P<0.05).Middle PD patients are more likely to have sarcopenia than early PD patients(P<0.05).Binary logistic regression analysis showed that UPDRS-III score(OR=1.094,95CI:1.007-1.190,P=0.035)was a risk factor for Parkinson ’s disease with sarcopenia,and BMI(OR=0.381,95CI:0.237-0.614,P<0.001)was a protective factor for Parkinson’s disease with sarcopenia.2.A total of 137 patients with Parkinson ’s disease were included in this study,including 41 patients in the low risk group,64 patients in the middle risk group and 32 patients in the high risk group.The results of univariate analysis showed that there were significant differences in the disease duration,UPDRS-III score,LEDD,HAMA,HAMD,ADL score,blood uric acid,SARC-Cal F score,calf circumference,grip strength and walking speed among the three groups of patients with fall risk(P<0.05).Pairwise comparison showed that there were statistically significant differences between the three groups in UPDRS-III score,LEDD and SARC-Cal F score(P<0.05).The course of disease,HAMA,serum uric acid,calf circumference and walking speed were only statistically significant in the difference between the high risk group and the low risk gr oup(P<0.05).There were significant differences in HAMD and ADL scores between the high risk group and the middle risk group,the high risk group and the low risk group(P<0.05).The difference of grip strength between high risk group and low risk group,middle risk group and low risk group was statistically significan(P<0.05)t.There were significant differences in clinical subtypes,H-Y grade,motor complications and diabetes history among the three groups(P<0.05).In terms of clinical subtypes,TD patien ts have a lower risk of falls than PIGD and mixed patients(P<0.05).On the H-Y classification,patients with early PD have a lower risk of falls than those with mid-stage PD(P<0.05).On the motor complications part,PD patients with motor complications have a higher risk of falls(P<0.05).On the diabetes part,PD patients with diabetes have a higher risk of falls.The results of multivariate ordered logistic regression analysis show that showed that UPDRSIII score was a risk factor for falls in PD patients(OR=1.104,95CI:1.043-1.169,P=0.001).LEDD was a risk factor for falls in PD patients(OR=1.002,95CI:1.001-1.005,P=0.041).SARC-Cal F score was a risk factor for falls in patients with Parkinson’s disease(OR=1.204,95CI:1.049-1.383,P=0.008).Conclusions:1.The prevalence of sarcopenia in patients with Parkinson ’s disease in early and middle stages was 9.49%.2.Disease duration,UPDRS-III score,H-Y stage,daily equivalent dose of levodopa,BMI,grip strength,pace,protein content,limb skeletal muscle m ass,body fat rate and basal metabolic rate of patients with Parkinson ’s disease in early and middle stage were correlated with sarcopenia.UPDRS-III score is an independent risk factor for sarcopenia in patients with early and middle stage Parkinson ’s disease,and BMI is a protective factor for sarcopenia in patients with early and middle stage Parkinson ’s disease.3.Disease duration,UPDRS-III score,H-Y grade,daily equivalent dose of levodopa,clinical subtype,presence or absence of motor complicati ons,presence or absence of diabetes,daily living ability score,anxiety score,depression score,SARC-Cal F score,blood uric acid concentration,calf circumference,grip strength,and pace of patients with early and middle stage Parkinson ’s disease were associated with the risk of falls.Among them,UPDRS-III score,daily equivalent dose of levodopa and SARC-Cal F score were independent risk factors for fall risk.4.Compared with patients with PD in early stage,patients with PD in middle stage have a higher risk of sarcopenia and falls.