Objective: The aims of the present study were to estimate prevalence of sarcopenia and dynapenia in patients with Parkinsonian syndromes and to investigate their association with the features of the disease.

Background: Chronic diseases are considered important determinants of sarcopenia. Parkinsonian syndromes are characterized by progressive disability, with reduction in mobility and in performance of activities of daily living.

Methods: The study population included consecutive outpatients (N=364) aged >=65 years, affected by Parkinsonian syndromes and attending a single movement disorder clinic. Skeletal muscle mass (SMM), strength and gait speed (GS) were assessed by bioimpedence analysis, handgrip dynamometry, and the 4-meter walking test. Sarcopenia was diagnosed using the EWGSOP criteria.

Results: In total, 235 patients (64.6%) had a diagnosis of Parkinson’s disease (PD). Low SMM index was recorded in 27 patients. Due to gait disturbances and postural instability, GS could not be measured in 98 patients and was found to be reduced in 61.3% of those assessed. Prevalence of sarcopenia and dynapenia were 6.6% and 75.5%, respectively. Sarcopenia tended to be higher in patients unable to perform GS assessment and was unrelated to the type of Parkinsonian syndrome. It was associated with older age, longer disease duration, more severe disease and higher disability in activities of daily living, as assessed by disease-specific clinical rating scale. Dynapenia was directly associated with parkinsonism other than PD, older age and disability, while regular physical therapy was a preventive factor. It was unrelated to disease duration and severity. Finally, the disability score of activities of daily living was inversely correlated with handgrip strength and GS, while no association was found with SMM index.

Conclusions: Being primarily motor disorders, Parkinsonian syndromes are characterized by progressive disability in performing activities of daily living. Impaired functional status is a prominent feature of this patient population, independently of disease duration and severity. Sarcopenia is mainly related to advancing disease and, due to a significant sparing of SMM, is an infrequent condition, likely to play a minor role in disability. Several factors could be responsible for this favourable body composition (e.g. motor symptoms, levodopa therapy) and deserve further investigation. The prognostic impact of sarcopenia also needs to be addressed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sarcopenia-and-dynapenia-in-patients-with-parkinsonism/