Motor profile and measures of physical function in people with Parkinson's disease in northern Tanzania

Introduction: Parkinson's disease (PD) is the second most common neurodegenerative disorder worldwide and is often associated with frailty and sarcopenia. The cardinal motor features include bradykinesia, rest tremor, rigidity and postural instability. In low-resource settings such as Tanzania and sub-Saharan Africa (SSA), data on motor burden and physical function in PD are limited.

Aims: To assess motor symptom burden and physical function in people with Parkinson's disease (PwP) in northern Tanzania.

Methods: A cross-sectional study was conducted involving 28 PwP in the Hai district of northern Tanzania. Validated tools were used, including the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Hoehn and Yahr (HY) staging, handgrip strength, and the Short Physical Performance Battery (SPPB). All participants had received levodopa treatment, however six reported recent interruptions to their access to medication.

Results: Motor burden was moderate, with a median HY stage of 2. Handgrip strength was low, with 57% (n=16) of participants meeting the European Working Group on Sarcopenia in Older People (EWGSOP) criteria for probable sarcopenia. Additionally, 79% (n=22) scored below the threshold for normal physical performance on the SPPB. 32% of participants were in an OFF state when clinical examinations were performed. Those with recent medication interruptions had a higher mean MDS-UPDRS-III score (45.6) than those without (37.4).

Conclusion: Moderate motor burden and poor physical function were prevalent among participants. Interruptions in medication access may contribute to greater symptom severity. Further diagnostic assessment for sarcopenia and community-based physiotherapy could help improve outcomes for PwP in SSA.