Weight Loss and Malnutrition in Patients with Parkinson's Disease: Current Knowledge and Future Prospects

Ma, Kai; Xiong, Nian; Shen, Yan; Han, Chao; Liu, Ling; Zhang, Guoxin; Wang, Luxi; Guo, Shichao; Guo, Xingfang; Xia, Yun; Wan, Fang; Huang, Jinsha; Lin, Zhicheng; Wang, Tao

doi:10.3389/fnagi.2018.00001

Cited by 175 publications

(195 citation statements)

References 208 publications

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“…Thus, the chewing problems may also contribute to the weight loss that is often seen in PD. 33 In the present study, almost half of the patients reported chewing and swallowing problems in the NOT-S.…”

Section: Discussion and Con Clus I Onsupporting

confidence: 46%

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Improvement of oral function and hygiene in Parkinson's disease: A randomised controlled clinical trial

Baram

Karlsborg

Bakke

2020

J of Oral Rehabilitation

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neurodegenerative disease with loss of dopaminergic neurons in the substantia nigra of the brain. It is a multisystem disorder clinically characterised by motor and non-motor (NM) symptoms. 1 The motor symptoms of PD include four cardinal features: bradykinesia (slowness of movements), rest tremor, rigidity and postural instability or gait impairment. 2 The NM symptoms include autonomic disturbances and neuropsychiatric dysfunctions such as depression, dementia and apathy. Most therapies are oriented towards symptomatic relief and do not have significant effect on the underlying disease process with respect Abstract Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder.It is associated with reduced oral health and impaired oro-facial function, but besides recommendations of dental visits and drooling treatment, there are little documented odontological treatment options. Objectives:To evaluate the effect of standardised home exercise jaw opening and chewing programmes, as well as home oral hygiene measures instructed and controlled by a trained dentist.Methods: Twenty-nine patients (median 65 years) with moderate to advanced PD participated in the project after informed consent. They were followed at a Neurology Department, were able to cooperate, and had stable medical treatment and nine also deep brain stimulation. The interventions were individual dental hygiene instruction, training of jaw opening (JawTrainer), and lip and chewing exercises (Ulmer Oral Screen and Proxident Fluoride Gum). The study was performed as a randomised controlled study. The treatment effect was evaluated after 2 and 4 months. The primary outcome was maximum unassisted jaw opening capacity, chewing time of a standardised apple slice, and the Simplified Debris Index. Results were analysed with Wilcoxon matched pairs test and Mann-Whitney U test (significance level P < .05).Results: Jaw opening, chewing time and hygiene were significantly improved 2 months from the start of the invention, respectively, 6%, 49%, and 25%, and the improvement was still significant after 4 months. No significant changes were found after the 2-month control period without intervention. Conclusion:The simple measures had a substantial and significant clinical effect which is promising despite the progressive nature of the PD.

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Section: Discussion and Con Clus I Onsupporting

confidence: 46%

“…33 In the present study, almost half of the patients reported chewing and swallowing problems in the NOT-S. non-pharmacological aids in PD. 33 In the present study, almost half of the patients reported chewing and swallowing problems in the NOT-S. non-pharmacological aids in PD.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 45%

Improvement of oral function and hygiene in Parkinson's disease: A randomised controlled clinical trial

Baram

Karlsborg

Bakke

2020

J of Oral Rehabilitation

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“…In fact, a decrease in olfactory function that occurs for a long period of time can decrease emotional memory of external stimuli, as reported in our previous work [16]. Instead, fatigue is one of the NMSs that affects about 50% of PD patients [10,20] and seems to be related to anxiety and apathy [20,45].…”

Section: Discussionmentioning

confidence: 59%

“…The weight change in PD patients is associated to worsening quality of life, infections, malnutrition, cognitive decline and bone fracture. Moreover, Ma and Colleagues [10] suggested that the body weight loss is related to a low density of nigrostriatal dopamine.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Olfactory and Gustatory Dysfunction and Motor Symptoms on Body Weight in Patients with Parkinson’s Disease

et al. 2020

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Background: Non-motor symptoms in Parkinson's disease (PD) are often associated with a negative impact on the patients' quality of life and on their weight regulation. The aim of this study was to assess the effect of olfactory and gustatory dysfunction, apathy, fatigue, depression, and motor symptoms on weight regulation in PD patients. Methods: We analyzed 112 participants, 63 PD patients (mean age ± SD: 69.2 ± 10.1), and 49 controls (mean age ± SD: 68 ± 9.6). For each participant we collected age, weight, height, BMI, olfactory and gustatory function, cognitive performance, apathy and fatigue. Results: Our data showed that 61.9% (n = 39) of PD patients had hyposmia, while 38.1% (n = 24) had anosmia. In PD patients, we observed a significant effect of Unified Parkinson's Disease Rating Scale (UPDRS), apathy, odor threshold, sweet perception and fatigue on weight regulation. Instead, there was no significant effect for depression and levodopa equivalent daily dosage (LEDD). Conclusion: Our results suggest that PD non-motor symptoms such as olfactory/gustatory deficits and mood disorders may influence body weight.Brain Sci. 2020, 10, 218 2 of 10 function has been observed [13,14]. Subjects with olfactory dysfunction typically show problems with food intake, reduced enjoyment in social life and become more prone to apathy and depression [15].The aim of this study was to evaluate the role of olfactory and gustatory dysfunction, apathy, fatigue, depression and motor symptoms on body weight in PD patients. Materials and Methods PatientsWe evaluated 112 participants (57 men and 55 women) in this study, 63 PD patients (mean age ± SD, 69.2 ± 10.1) and 49 healthy controls (mean age ± SD, 68 ± 9.6). In this study, 12 patients from our previous studies [16,17] were enrolled. Data collection started from September 2018 to October 2019 and further participants were recruited at the Movement Disorders Center of the University of Cagliari during regular out-patient follow-up examination. PD was diagnosed according to Gelb criteria [18] and United Kingdom Parkinson's Disease Society Brain Bank criteria [19].Controls were identified among relatives of non-Parkinsonian patients attending the out-patient department during the same period without evidence of any neurological disease. Exclusion criteria were atypical Parkinsonism, dementia, psychiatric conditions interfering with study participation, and chronic/acute rhinosinusitis. In order to evaluate weight differences between patients and controls all participants were divided into two age groups: 45-65 years (n = 44), and ≥ 66 years (n = 68).

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Chinese expert consensus on prevention and intervention for the elderly with malnutrition (2022)

Mao

Liu

et al. 2022

Aging Medicine

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Malnutrition is a state of altered body composition and body cell mass due to inadequate intake or utilization of energy or nutrients, leading to physical and mental dysfunction and impaired clinical outcomes. As one of the most common geriatric syndromes, malnutrition in the elderly is a significant risk factor for poor clinical outcomes, causing a massive burden on medical resources and society. The risk factors for malnutrition in the elderly are diverse and include demographics, chronic diseases, and psychosocial factors. Presently, recommendations for the prevention and intervention of malnutrition in the elderly are not clear or consistent in China. This consensus is based on the latest global evidence and multiregional clinical experience in China, which aims to standardize the prevention and intervention of malnutrition in the elderly in China and improve the efficacy of clinical practice and the prognosis of elderly patients.

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Weight Loss and Malnutrition in Patients with Parkinson's Disease: Current Knowledge and Future Prospects

Cited by 175 publications

References 208 publications

Improvement of oral function and hygiene in Parkinson's disease: A randomised controlled clinical trial

Improvement of oral function and hygiene in Parkinson's disease: A randomised controlled clinical trial

Effect of Olfactory and Gustatory Dysfunction and Motor Symptoms on Body Weight in Patients with Parkinson’s Disease

Chinese expert consensus on prevention and intervention for the elderly with malnutrition (2022)

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