Abstract Details

Title Frailty in Prodromal Parkinson’s Disease in Medicare Beneficiaries

Topic Movement Disorders

Presentation(s) P9 - Poster Session 9 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-022

Objective To investigate the association between frailty and Parkinson’s disease (PD) during the prodromal phase compared to controls.

Background Frailty is a decline in physical function, reserve, and resistance to stressors. PD is a multisystem neurodegenerative disease. Coexistence of PD and frailty drives clinical complexity. Understanding the relationship between frailty and prodromal PD may allow for earlier intervention in at-risk individuals in order to delay or prevent complications and reduce mortality.

Design/Methods We conducted a population-based case-control study of incident PD cases (N=82,560) and controls (N=96,482) age 70-90 identified in 2009. We used Medicare data 2004-2009 and examined frailty in five 12-month time windows during the prodromal period using claims-based frailty index (CFI) (range: 0-1 and categorized as nonfrail (<0.25), mildly frail (0.25–0.34), moderately-to-severely frail (≥0.35)). For each time window, we calculated odd ratios (ORs) and 95% confidence intervals (CIs) for the association between frailty as an exposure and the outcome of PD, adjusted for age, sex, race/ethnicity, smoking, and healthcare utilization. We examined variables in CFI that were positively associated with PD in the 12-months prior to diagnosis.

Results Mild frailty (OR=1.70, 95% CI: 1.62-1.78) and moderate-to-severe frailty (OR=1.29, 95% CI: 1.16-1.43) were positively associated with PD five years prior to diagnosis. This association strengthened in the final year prior to diagnosis both with mild frailty (OR=7.75, 95% CI: 7.51-7.99) and moderate-to-severe frailty (OR=10.22, 95% CI: 9.63-10.80). In the 12-months prior to diagnosis, the CFI variable “organic psychotic conditions”, which includes diagnoses for dementia, depression, and anxiety, had the most marked association with PD (OR=4.63, 95% CI: 4.50-4.77).

Conclusions PD cases are frailer than controls in the prodromal period for at least 5 years prior to diagnosis. Common psychiatric symptoms of PD had the strongest association with PD in the 12 months prior to diagnosis.

Authors/Disclosures
George K. Karway, PhD (Barrow Neurological Institute) PRESENTER	Dr. Karway has nothing to disclose.
Jordan A. Killion, PhD (Barrow Neurological Institute)	Dr. Killion has received personal compensation for serving as an employee of CommonSpirit Health. The institution of Dr. Killion has received research support from The Michael J. Fox Foundation for Parkinson's Research (MJFF-000939). The institution of Dr. Killion has received research support from Department of Defense Grant (PD190057). The institution of Dr. Killion has received research support from Barrow Neurological Foundation. The institution of Dr. Killion has received research support from Kemper and Ethel Marley Foundation. The institution of Dr. Killion has received research support from Moreno Family.
Irene Faust, MPH (Barrow Neurological Institute)	Ms. Faust has nothing to disclose.
Kassu Mehari Beyene, PhD	Dr. Beyene has nothing to disclose.
Brad A. Racette, MD, FAAN (Barrow Neurological Institute)	Dr. Racette has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for American Regent. Dr. Racette has received personal compensation in the range of $500-$4,999 for serving as a advisory council with NIEHS.
ALEJANDRA CAMACHOSOTO, MD	The institution of Dr. CAMACHOSOTO has received research support from Michael J Fox Foundation . The institution of Dr. CAMACHOSOTO has received research support from NIH NCATS KL2 Career Development.

��ɫ��

��ɫ��