Increased prevalence of undernutrition in Parkinson's disease and its relationship to clinical disease parameters

Abstract

An anthropometric study was performed in 95 subjects (53 male, 42 female) with Parkinson's disease. Weight, height, triceps and biceps skin-fold thicknesses, and mid-arm circumference were recorded. A high incidence of undernutrition was found (23.6% of males and 22.5% of females, as defined by recent British guidelines). A subgroup of severely disabled patients with Parkinson's disease had a significantly lower mean body mass index than a similarly disabled control group with chronic pyramidal upper motor neuron lesions (males 20.6 v 23.2 kg/m2 p < 0.05; females 20.6 v 26.6 kg/m2 p < 0.01), suggesting that the undernutrition is not due to chronic illness or immobility alone. Correlation between anthropometric indices and clinical features of disease demonstrated that the presence of moderate or severe dyskinetic movements was the clinical parameter most strongly related to undernutrition. The reduction in anthropometric indices was most marked for skin fold thickness (related to percentage body fat) and least for arm muscle circumference (related to lean body mass); therefore the weight loss seen in Parkinson's disease is primarily due to fat loss rather than muscle loss.

Is underweightness still a major problem in Parkinson's disease patients?

“…All the previous studies have reported lower mean BMIs than the mean values we found in this study (men 23.0 -25.4 vs 27.0 kg=m 2 ; women 22.0 -22.6 vs 26.9 kg=m 2 ; both sexes together 23.5 -24.4 vs 27.0 kg=m 2 ; Markus et al, 1993;Beyer et al, 1995;Durrieu et al, 1992;Jankovic et al, 1992). Also the proportion of overweight patients was lower than in our study (20 -30% vs 62%) (Markus et al, 1993;Abbott et al, 1992).…”

“…Also the proportion of overweight patients was lower than in our study (20 -30% vs 62%) (Markus et al, 1993;Abbott et al, 1992). However, the difference versus normal controls was not always statistically significant.…”

“…The inverse correlation between duration of disease and BMI was found also by Markus et al (1993) in a cohort of 95 PD patients, who reported that significant reductions in BMI were confined to the subgroup of patients with a duration of disease of over 15 years. Beyer et al (1995) reported an inverse correlation between advancing of the disease and BMI, but significance was achieved by the correlation with severity of disease, not with duration of disease.…”

The Role of Ghrelin, Neuropeptide Y and Leptin Peptides in Weight Gain after Deep Brain Stimulation for Parkinson’s Disease

“…L -dopa has also been implicated in weight loss via a lypolitic effect [32] . Several other hypothesis have been proposed including a decrease of food intake, loss of appetite, decreased nutrient absorption, hypothalamic dysregulation, depression, use of neuroleptics, nausea and anorexia (the latter two as side effects of antiparkinsonian medication) [33][34][35][36] . Therefore, it could be suggested that WG following DBS could only be a homeostatic response of the body in those who had lost weight during the course of PD.…”

The scientific and clinical basis for the treatment of Parkinson disease (2009)

“…Although some studies have found that severe dyskinesias can contribute to weight loss, 1003 others have not found this association. 1002 It is also important to recognize that the weight loss that occurs in PD may result from patients receiving higher dosages of levodopa per unit of body mass, which tends to aggravate dyskinesia, thereby setting up a vicious cycle.…”