Daily physical function and frailty in persons with Parkinson's disease: a focus on females

Roland, Kaitlyn P.
March 2013
Applied Physiology, Nutrition & Metabolism;Mar2013, Vol. 38 Issue 3, p358
Academic Journal
Persons with Parkinson's disease (PD) are often excluded from frailty studies, and thus little is known about how frailty influences decline in physiological capacity in persons with PD. Impaired physiological capacity impacts the ability to remain physically active, which reduces physical function that is necessary for independent living. The overall purpose of this dissertation was to examine physiological capacity (i.e., muscle activation patterns) and physical activity in males and females with PD during routine daily activities to determine whether they influence physical function and frailty. An extensive literature review of sex differences in PD highlighted that greater declines in gait speed, balance, and motor function occur in females compared with males. This dissertation demonstrated persons with PD, especially females with PD, were weaker and have less muscle quiescence, as measured with gaps in the electromyography, compared with controls and males with PD. These results provide insight into mechanisms (i.e., physiological capacity) that determine PD and sex-related declines in functional performance. In addition, greater muscle activity and less quiescence in females with PD may perpetuate frailty through increased muscle fatigue and slowness of movement. Females with PD are more vulnerable to prefrailty than males and factors that are associated with frailty are quality of life (QoL) and self-reported exhaustion. The neuromuscular changes associated with frailty exacerbate PD, which may create greater muscle fatigue that results in self-reported exhaustion. In conclusion, research presented within this dissertation demonstrates that addressing frailty in PD is important, especially in females who are at greater risk for functional decline. This research presents new knowledge by suggesting that frail females with PD remain physically active during daily life and that disease management may better reflect frailty than disease severity or duration. Understanding how frailty concurrently exists with PD and how these conditions progress within the aging adult may enhance identification and implementation of management strategies aimed at improving functional independence and QoL.


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