Objective: To evaluate the prevalence of frailty and correlation with motor and non-motor symptoms as well as MRI atrophy and white matter hyperintensities in Parkinson’s disease.

Background: Frailty is an important modulator of disability in the elderly. No studies addressed frailty impact on brain atrophy/white matter burden, clinical presentation and progression in Parkinson’s disease.

Method: Consecutive Parkinson’s disease patients underwent a comprehensive motor and non-motor evaluation and geriatric assessment using multidimensional prognostic index (MPI). A subset of 60 patients underwent MRI with assessment of atrophy and white matter hyoperintensities by visual rating.

Results: One-hundred sixty five outpatients with PD diagnosis (mean age 68.8 y, mean disease duration 8.3 years) entered the study. Pre-Frailty assessed by MPI was presented by 38.5 % of patients and correlated with age and disease duration. When adjusting for these variables, MPI correlated with motor and non-motor symptoms, prevalence of prevalence of orthostatic hypotension, RBD and depression and MRI atrophy but not with White matter lesion burden. At 2-years follow-up, frailty predict worse cognitive and motor progression when adjusted for disease severity.

Conclusion: Frailty is a possible important modulator of pathology and brain vulnerability in Parkinson’s disease and could explain different severity in motor and non-motor symptoms. Longitudinal studies are warranted to evaluate the impact of frailty in disease progression.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/frailty-as-clinical-modulator-of-brain-damage-and-progression-in-parkinsons-disease/