What increases the risk of malnutrition in Parkinson's disease?

Tomić, Svetlana; Pekić, Vlasta; Popijać, Željka; Pučić, Tomislav; Petek, Marta; Kuric, Tihana Gilman; Mišević, Sanja; Kramarić, Ružica Palić

doi:10.1016/j.jns.2017.01.070

Cited by 26 publications

(24 citation statements)

References 25 publications

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“…Overall, we observed that 43% of patients were at risk of malnutrition and 21% were undernourished. These data are in line with the published literature, which reports a 0-24% prevalence of malnutrition in PD, depending on the study methodology and definition criteria [20]. Interestingly, we found that dyskinesia alone is not a determinant of nutritional status, whereas disease severity (expressed as Hoehn Yahr stage and MDS-UPDRS-III score), dysphagia, feeding difficulties (expressed as EdFED-Q score), dosage of dopaminergic therapies (expressed as LEDD/kg) and developing or worsening of a pre-existing PNP correlate with the nutritional state.…”

Section: Discussionsupporting

confidence: 91%

“…Interestingly, we found that dyskinesia alone is not a determinant of nutritional status, whereas disease severity (expressed as Hoehn Yahr stage and MDS-UPDRS-III score), dysphagia, feeding difficulties (expressed as EdFED-Q score), dosage of dopaminergic therapies (expressed as LEDD/kg) and developing or worsening of a pre-existing PNP correlate with the nutritional state. These data confirm the association between late-stage PD and malnutrition [20]. It is of relevance that six of our patients successfully used the PEG-J (AbbVie, North Chicago, IL, USA) tube to supplement their daily food intake with nocturnal enteral feeding.…”

Section: Discussionsupporting

confidence: 84%

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Levodopa/carbidopa intestinal gel infusion and weight loss in Parkinson's disease

Fabbri

Zibetti

Beccaria

et al. 2018

Euro J of Neurology

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Background and purpose Weight loss (WL) is a frequent yet under‐recognized complication of levodopa/carbidopa intestinal gel (LCIG) infusion, as well as a milestone of Parkinson's disease (PD) disability progression. The complex association between WL, poor nutritional status, motor complications and PD progression, however, remains unclear. Methods Consecutive consenting patients with PD treated with LCIG (n = 44; PD duration, 18.3 ± 6.5 years) were enrolled in an open‐label observational study assessing the extent of WL occurring during LCIG treatment. As secondary aims, we correlated the nutritional status, as detected by the Mini Nutritional Assessment, with the severity of motor symptoms [Movement Disorder Society Unified Parkinson's Disease Rating Scale part III], motor complications (Unified Parkinson's Disease Rating Scale part IV), activities of daily living (Schwab and England scale), cognitive impairment (Mini Mental State Examination), depression (Beck Depression Inventory), difficulties in feeding (Edinburgh Feeding Evaluation in Dementia Questionnaire) and levodopa equivalent daily dose (LEDD). Results There was an average WL of 9.9 ± 10.5% (7.6 ± 7.1 kg) over an LCIG treatment period of 51.6 ± 28.5 months. The extent of WL correlated with the percentage of the waking day spent with dyskinesia (P < 0.05). The nutritional status correlated with motor symptom severity (P < 0.01), dysphagia (P < 0.01) and LEDD (P < 0.01). Conclusions Weight loss may occur in patients with PD undergoing LCIG in correlation with the percentage of the waking day spent with dyskinesia. Regardless of the extent of WL, the nutritional status correlated with higher LEDD, as well as with indices of disease progression, such as motor symptom severity and dysphagia.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 84%

Levodopa/carbidopa intestinal gel infusion and weight loss in Parkinson's disease

Fabbri

Zibetti

Beccaria

et al. 2018

Euro J of Neurology

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“…Parkinson's disease gives rise to alterations in the dopaminergic, serotonergic, noradrenergic and cholinergic neurotransmitter systems. Not only dysphagia, but also delayed gastric emptying, constipation, disturbed hand-mouth coordination and comorbid mood disorders may have a serious impact on nutritional status in these patients [47]. Medications such as NSAIDS, bisphosphonates and potassium supplements may also cause dysphagia [48].…”

Section: Pathological Medical Conditions and Polypharmacymentioning

confidence: 99%

Eating disturbances in the elderly: A geriatric-psychiatric perspective

Bulut

Khoury

Lee

et al. 2019

NHA

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The prevalence of malnutrition among older adults is increasing, leading to poor health outcomes and increased mortality. This review sheds light on the different etiologies of eating disturbances in the elderly and discusses assessment tools and treatment strategies. Older adults are found to be more prone to nutritional deficiencies and weight loss due to age related physiological and psychosocial changes, in addition to pathological medical and psychiatric disorders. The short form of the Mini Nutritional Assessment is considered the most commonly used screening tool in older persons. Individuals identified as malnourished or at high risk of malnutrition would benefit from comprehensive treatment plans according to the underlying etiology. Those involve environmental changes, oral nutritional supplements and ultimately pharmacotherapy.

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“…Weight loss can also precede the motor stage. Whilst the prevalence of weight loss ranges from 0 to 24%, between 3 and 60% of patients with Parkinson's disease are reported to be at risk of malnutrition (Sheard et al, 2011 ; Tomic et al, 2017 ). In particular reduced energy intake due to dysphagia, poor dental status, gastrointestinal dysfunction and increased energy expenditure due to rigidity, tremor, and dyskinesia but also dementia, anxiety and depression have been found to be associated with malnutrition in Parkinson's disease (Beyer et al, 1995 ; Kashihara, 2006 ; Lorefält et al, 2009 ; Sheard et al, 2013 ; Fávaro-Moreira et al, 2016 ; Lindskov et al, 2016 ; Mukherjee et al, 2016 ).…”

Section: Disease-specific Aspects Of Malnutrition In Neurogeriatric Pmentioning

confidence: 99%

Disease Specific Aspects of Malnutrition in Neurogeriatric Patients

Prell

Perner

2018

Front. Aging Neurosci.

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Malnutrition in elderly patients is a common condition. Nevertheless, there is evidence on specific risk factors and problems of malnutrition in geriatric patients with neurological diseases. In this review, we summarize recent knowledge on malnutrition in different neurological diseases with a focus on elderly patients. This overview also provides strategies for a more specific and profound assessment of neurogeriatric patients to improve identification and treatment of malnutrition. Early and consequent treatment of malnutrition can lead to a decreased progression of the neurological disease and to a better quality of life in geriatric patients.

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What increases the risk of malnutrition in Parkinson's disease?

Cited by 26 publications

References 25 publications

Levodopa/carbidopa intestinal gel infusion and weight loss in Parkinson's disease

Levodopa/carbidopa intestinal gel infusion and weight loss in Parkinson's disease

Eating disturbances in the elderly: A geriatric-psychiatric perspective

Disease Specific Aspects of Malnutrition in Neurogeriatric Patients

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