Frailty and cognitive impairment in Parkinson's disease: a systematic review.

BACKGROUND: Frailty can lead to increased vulnerability in older people and patients with Parkinson's disease (pwPD) and worsen their health conditions. These patients can also develop cognitive function impairment. The objective is to analyze whether there is a relationship between frailty and cognitive impairment in pwPD, and to find out which instruments to use for its evaluation. METHODS: Publications were searched in PubMed, Medline, Web of Science, Cinalh, Cochrane Library, Embase, Phycinfo, and Scopus. The results were measured with the instruments that are used to assess frailty and cognitive impairment, and analyze their relationship. RESULTS: Two hundred seventy-one articles were identified, of which 12 met the inclusion criteria. All studies assessed frailty and cognitive function in pwPD. Five studies analyzed the relationship between frailty and cognitive impairment. The most used instruments were the Fried scale followed by the Clinical Frailty Scale (CFS) for frailty. Cognitive impairment was mostly evaluated with the Mini-Mental State Examination and the Montreal Cognitive Assessment. The prevalence data ranged from 20.2 to 51.5% with the Fried scale and from 35.6 to 83.9% with the CFS. Cognitive impairment was present in 15 to 45.2% of the pwPD. CONCLUSION: Analysis of the included studies shows a relationship between frailty and cognitive impairment in pwPD. There was significant variability in the application of the scales used, which influences the prevalence data. More observational and experimental studies are needed to provide more evidence on this association and to determine which is the optimal tool to identify frailty in pwPD using multidimensional scales.

Neuromodulación periférica en el síndrome de vejiga hiperactiva en mujeres: una revisión sistemática / Peripheral neuromodulation in women with overactive bladder syndrome: a systematic review

Introducción: El síndrome de vejiga hiperactiva (VH) es una disfunción urológica caracterizada por urgencia miccional, aumento de la frecuencia de las micciones, nicturia y puede llevar asociado incontinencia urinaria de urgencia. Dentro de las técnicas de tratamiento, la neuromodulación periférica del nervio tibial posterior (NMTP) está reconocida internacionalmente como una de las vías de abordaje, aunque no se ha probado un protocolo óptimo. El objetivo de esta revisión es conocer la evidencia disponible sobre cuál es el protocolo de la técnica de NMTP más empleado en la obtención de buenos resultados en el tratamiento de VH en mujeres.Adquisición de la evidenciaSe llevó a cabo una revisión sistemática de la literatura científica en las bases de datos Pubmed, Embase, WOS y Scopus. Se obtuvieron 222 resultados, con 58 duplicados, de los cuales 8 estudios cumplieron los criterios de inclusión establecidos, todos ellos ensayos clínicos aleatorizados.Síntesis de la evidenciaLa técnica de NMTP más utilizada en los trabajos incluidos que muestran estos resultados beneficiosos en mujeres con VH es la percutánea con una aguja colocada 5-6cm en posición proximal al maléolo tibial, por detrás del borde de la tibia y con los parámetros de 200μs de duración de impulso, 20Hz de frecuencia, 30 minutos de tiempo por sesión y con una frecuencia que podría ser de una sesión por semana durante 12 semanas.ConclusiónLa NMTP puede tener efectos beneficiosos y seguros a corto plazo en la VH en mujeres. A pesar de mostrar mejorías estadísticamente significativas en los síntomas clínicos, son necesarias más investigaciones para poder obtener evidencias científicas claras sobre el tipo de protocolo óptimo para el tratamiento de la VH en mujeres. (AU)

Introduction: Overactive bladder syndrome (OBS) is a urological disorder characterized by urinary urgency, increased frequency, nocturia, and may be associated with urge urinary incontinence. Posterior tibial nerve peripheral neuromodulation (PTNS) is globally recognized within the treatment options available, although an optimal protocol has not been tested. The objective of this review is to collect the evidence available on the most widely used protocol of the PTNS technique in obtaining good results in the treatment for women with OBS.Evidence acquisitionA systematic review of the scientific literature was carried out in PubMed, Embase, WoS and Scopus databases. A total of 222 results were obtained, with 58 duplicates, of which 8 studies met the established inclusion criteria, all of them randomized clinical trials.Evidence synthesisThe included works show that the most widely used PTNS technique with beneficial results in women with OBS is the percutaneous route with a needle placed 5-6cm proximal to the tibial malleolus, posterior to the edge of the tibia, with the following parameters: 1 weekly session of 30minutes duration for 12 weeks, the use of pulse widths of 200μs with frequency of 20Hz.ConclusionPTNS may have beneficial and safe short-term effects in women with OBS. Despite showing statistically significant improvements in clinical symptoms, further research is needed to obtain clear scientific evidence on the optimal protocol for treating women with OBS. (AU)

Peripheral neuromodulation in women with overactive bladder syndrome: a systematic review. / Neuromodulación periférica en el síndrome de vejiga hiperactiva en mujeres: una revisión sistemática.

INTRODUCTION: Overactive bladder syndrome (OBS) is a urological disorder characterized by urinary urgency, increased frequency, nocturia, and may be associated with urge urinary incontinence. Posterior tibial nerve peripheral neuromodulation (PTNS) is globally recognized within the treatment options available, although an optimal protocol has not been tested. The objective of this review is to collect the evidence available on the most widely used protocol of the PTNS technique in obtaining good results in the treatment for women with OBS. EVIDENCE ACQUISITION: A systematic review of the scientific literature was carried out in PubMed, Embase, WoS and Scopus databases. A total of 222 results were obtained, with 58 duplicates, of which 8 studies met the established inclusion criteria, all of them randomized clinical trials. EVIDENCE SYNTHESIS: The included works show that the most widely used PTNS technique with beneficial results in women with OBS is the percutaneous route with a needle placed 5-6cm proximal to the tibial malleolus, posterior to the edge of the tibia, with the following parameters: 1 weekly session of 30minutes duration for 12 weeks, the use of pulse widths of 200µs with frequency of 20Hz. CONCLUSION: PTNS may have beneficial and safe short-term effects in women with OBS. Despite showing statistically significant improvements in clinical symptoms, further research is needed to obtain clear scientific evidence on the optimal protocol for treating women with OBS.