Objective: To systematically review the prevalence of sarcopenia in Parkinson’s disease (PD) and atypical parkinsonian syndromes (aPS), how prevalence differs with PD stage and between PD and aPS.

Background: Sarcopenia is characterised by loss of strength and skeletal muscle mass. Like PD, its prevalence increases with age and has important health implications. There is evidence that sarcopenia is more prevalent in PD than in age matched cohorts. Shared features of pathogenesis include IL6 driven neuroinflammation and mitochondrial dysfunction. However the degree to which sarcopenia and parkinsonian disorders co-occur or the extent to which sarcopenia correlates with disease stage is unknown.

Method: Predefined literature search strategies were used on MEDLINE, EMBASE, Scopus and Web of Science. Studies conducted in people with PD or aPS reporting on the prevalence of sarcopenia or those that provided enough data to compute this using validated sarcopenia definitions were included. Risk of bias was assessed using the AXIS tool.

Results: 1683 (199 duplicates) studies were identified through the search; 67 were assessed in full and 14 met inclusion criteria. 11 gave estimates of sarcopenia and 3 probable sarcopenia. The average score for study quality was 14.5/20 (range 11-18). The mean prevalence of sarcopenia in parkinsonian patients was 17.9% (range 2-31.4%). The mean prevalence of probable sarcopenia (i.e. low muscle strength) was 49.1% (range 17.5-76.7%). Across all studies reporting on non parkinsonian controls, sarcopenia was more prevalent in those with parkinsonian disorders. The combined odds ratio was 2.49 (p <0.0001). Six studies reported a mean UPDRS III score. There was a positive correlation between mean UPDRS III score and the prevalence of sarcopenia though this finding was not consistently reflected in individual studies. Three studies commented on the prevalence of sarcopenia in aPS. There was little agreement between studies as to whether sarcopenia is more prevalent in PD or aPS.

Conclusion: Sarcopenia is a prevalent and important issue in parkinsonian disorders. Probable sarcopenia, defined by muscle weakness, is especially common. Recognition of this should prompt clinical testing and provision of appropriate interventions to minimise negative clinical outcomes associated with movement disorders being compounded by muscle weakness.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-prevalence-of-sarcopenia-in-parkinsons-disease-and-related-disorders/