Self-reported autonomic dysfunction could be a predictive marker for sarcopenia in Parkinson's disease

Area of Science:

• Geriatric Medicine
• Neurology
• Movement Disorders

Background:

• Parkinson's disease (PD) commonly presents with both motor and non-motor symptoms.
• Autonomic dysfunction is a frequent non-motor symptom in PD.
• The relationship between autonomic dysfunction and sarcopenia in PD is not well-established, despite sarcopenia's association with motor symptoms.

Purpose of the Study:

• To investigate the association between autonomic dysfunction and sarcopenia in patients with Parkinson's disease.
• To determine if autonomic dysfunction severity predicts sarcopenia in PD.
• To identify specific domains of autonomic dysfunction that are most strongly associated with sarcopenia.

Main Methods:

• A cohort of 124 Parkinson's disease patients (Hoehn and Yahr stages 1-3) without dementia were assessed.
• Autonomic dysfunction severity was measured using the Scales for Outcomes in Parkinson's Disease-Autonomic Questionnaire (SCOPA-AUT).
• Sarcopenia was diagnosed using the 2019 Asian Diagnostic Criteria, with statistical analysis including Poisson regression and ROC analysis.

Main Results:

• Sarcopenia was present in 25% (31/124) of the study participants.
• Higher SCOPA-AUT scores were significantly associated with sarcopenia (PR 1.078, p < 0.001).
• Gastrointestinal, urinary, and pupillomotor domains of the SCOPA-AUT showed significant associations with sarcopenia, with gastrointestinal functioning being the strongest predictor (AUC 0.744).

Conclusions:

• Elevated autonomic dysfunction, especially affecting gastrointestinal function, may serve as an effective predictive marker for sarcopenia in Parkinson's disease.
• The SCOPA-AUT questionnaire and its gastrointestinal domain show promise for identifying PD patients at risk of sarcopenia.
• These findings highlight the importance of assessing autonomic function in the management of sarcopenia in PD.