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Weight loss in elderly patients with Parkinson's disease
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Department of Neuroscience and Locomotion, Geriatrics. Linköping University, Faculty of Health Sciences.
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to investigate possible factors concerning weight loss in elderly patients with untreated, as well as treated Parkinson's disease (PD) and to compare PD patients with age and sex matched controls. Twenty-eight PD patients (15 newly diagnosed and 13 previously treated) and 28 sex and age matched controls were included in the study.

Data on body weight, body fat mass, lean body mass, PD symptoms, cognitive function, dysphasia, oral and dental state, resting energy expenditure, food habits, olfactory ability and physical activities were collected prospectively, and all variables were assessed repeatedly three times with one year between investigations: Baseline, year 1 and year 2. The previously treated PD patients and their controls were assessed twice, at year 1 and year 2. After one year, when the de novo PD patients had been optimally treated with L-dopa, the two groups of PD patients were combined into one group for the purpose of analysis.

Twenty-six of the PD patients were able to participate to the end of the study, and the results were compared with those of their 26 controls. The PD patients had lower housework activity, a longer period of daily rest, fewer could do their own food shopping and cooking and more patients had impaired olfaction and presence of dysphagia, both at year 1 and at year 2. At year two, the PD patients also had lower body weight, body fat mass, lean body mass, physical activity and mobility. The PD patients had a higher number of eating events, compared with the controls at year one, but at year two the patients consumed fewer high quality snacks than their controls. There were no significant differences between PD patients and their controls with regard to daily intakes of energy, protein, fat and carbohydrates.

Nineteen of the PD patients lost body weight between year one and year two. In the weight losing patients, the PD symptoms, L-dopa dosage, and energy intake (kcal/kg body weight) increased as did their daily recumbent rest, while their cognitive function decreased. Multiple regression analysis showed that women with low cognitive function were predisposed to weight loss. The consumption of solid food decreased.

Conclusion: Weight loss was common in PD patients, in spite of increased energy intake. Food habits changed toward a lower number of adequate foods and their intake of solid food decreased. It has to be discussed whether weight loss in PD patients is part of this neurodegenerative process and L-dopa treatment could contribute to the weight loss.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2005. , 46 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 896
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-33457Local ID: 19478ISBN: 91-85299-10-3 (print)OAI: oai:DiVA.org:liu-33457DiVA: diva2:254280
Public defence
2005-05-20, Berzeliussalen, Hälsouniversitetet, Linköping, 13:00 (Swedish)
Opponent
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2012-09-28Bibliographically approved
List of papers
1. Does l-dopa treatment contribute to reduction in body weight in elderly patients with Parkinson's disease?
Open this publication in new window or tab >>Does l-dopa treatment contribute to reduction in body weight in elderly patients with Parkinson's disease?
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2005 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 111, no 1, 12-20 p.Article in journal (Refereed) Published
Abstract [en]

Objective –  Many patients with Parkinson's disease (PD) lose weight also early during the disease. The objective of the study was to investigate possible causative factors for this loss.

Materials and methods –  In this report, 28 PD patients and 28 age- and sex-matched controls were repeatedly assessed with the focus on body weight, body fat mass, dysphagia, olfaction, physical activity, PD symptomatology and drug treatment.

Results –  Weight loss was seen in PD patients both before and during l-dopa treatment.

Conclusion –  The underlying disease could play a role, but our results also suggest that l-dopa per se could contribute to the weight loss.

Keyword
Parkinson's disease, L-dopa, weight loss, body fat mass
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28547 (URN)10.1111/j.1600-0404.2004.00364.x (DOI)13700 (Local ID)13700 (Archive number)13700 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2012-09-28Bibliographically approved
2. Factors of importance for weight loss in elderly patients with Parkinson's disease
Open this publication in new window or tab >>Factors of importance for weight loss in elderly patients with Parkinson's disease
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2004 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 110, no 3, 180-187 p.Article in journal (Refereed) Published
Abstract [en]

Objective –  Weight loss is reported frequently in patients with Parkinson's disease (PD). The objective of this study was to find the underlying factors of this phenomenon.

Participants and methods –  Twenty-six l-dopa-treated patients with PD and 26 age- and sex-matched healthy controls were assessed twice within a 1-year interval. Body weight, body fat mass, resting energy expenditure, physical activity, energy intake, thyroid hormones and cognitive function were investigated.

Results –  Nineteen (73%) of the PD patients lost body weight, although energy intake and the time for rest increased. Weight loss was most marked in patients with more severe PD symptoms and in whom cognitive function had decreased. Multiple regression analyses showed that determinants for weight loss were female gender, age and low physical activity.

Conclusion –  Weight loss was common in PD patients, in spite of the increased energy intake and was most obvious in patients with increased PD symptoms and decreased cognitive function.

Keyword
Parkinson's disease, weight loss, body fat mass, energy expenditure, energy intake, thyroid hormones, physical activity, cognitive function
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-46206 (URN)10.1111/j.1600-0404.2004.00307.x (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2012-09-28Bibliographically approved
3. Food habits and intake of nutrients in elderly patients with Parkinson's disease
Open this publication in new window or tab >>Food habits and intake of nutrients in elderly patients with Parkinson's disease
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2006 (English)In: Gerontology, ISSN 0304-324X, E-ISSN 1423-0003, Vol. 52, no 3, 160-168 p.Article in journal (Refereed) Published
Abstract [en]

Background: Weight loss is reported frequently in patients with Parkinson´s disease also early during the disease.

Objective: To investigate food habits and nutrient intake in elderly Parkinson´s disease patients compared with matched controls, as well as to compare PD patients with and without weight loss.

Methods: Twenty-six elderly free-living patients with PD, and 26 sex- and age-matched healthy controls, were assessed twice with one year interval between. All food consumed was recorded over 3 consecutive days. Food habits were assessed with the Food Based Concept for Classification of Eating Episodes and intakes of energy and nutrients were calculated. PD symptoms, olfaction, swallowing function, daily activities and serum concentration of different nutri ents were investigated.

Results: After 1 year, the PD patients decreased their intakes of daily high quality snacks from 0.5 ± 0.7 to 0.3 ± 0.3 (p < 0.05) and their prepared complete meals from 0.8 ± 0.3 to 0.6 ± 0.3 (p < 0.05), while their daily number of prepared incomplete meals increased from 0.2 ± 0.2 to 0.3 ± 0.3 (p < 0.01). PD patients with weight loss increased their daily intakes of fat by 12 ± 34 g and their energy intake per kg body weight increased by 21 ± 31 kJ (p < 0.05), respectively, and this was higher than in those without weight loss (p < 0.01). PD patients required more help with buying and cooking food compared with the controls.

Conclusions: PD patients’ food habits changed so that they consumed a lower number of prepared complete meals. PD patients with weight loss had a higher intake of fat and energy than those without weight loss, although this was obviously not sufficient to prevent weight loss. Impaired absorption of fat in PD should be discussed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-34088 (URN)10.1159/000091825 (DOI)20789 (Local ID)20789 (Archive number)20789 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2012-09-28Bibliographically approved
4. Avoidance of solid food in weight losing older patients with Parkinson's disease
Open this publication in new window or tab >>Avoidance of solid food in weight losing older patients with Parkinson's disease
2006 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, no 11, 1404-1412 p.Article in journal (Refereed) Published
Abstract [en]

Aim.  The aim of this paper was to investigate to what extent parkinsonian symptoms, including mild dysphagia and other eating problems, could influence the choice of consistency and the amount of food intake and if this could be related to weight loss as an expression of the underlying neurodegenerative process.

Background.  Previous studies show that patients with Parkinson's disease tend to lose body weight even early during the disease.

Design.  The design was a longitudinal prospective study.

Methods.  Twenty-six free-living Parkinson's disease patients and 26 age- and sex-matched controls were investigated twice, with one-year apart, with focus on Parkinson's disease symptoms, as well as swallowing function. Intake of food items and food consistency were assessed by food records, completed over three consecutive days at each investigation.

Results.  In patients with weight loss, motor symptoms, problems with activities of daily living and problems with eating, related to motor symptoms, increased and they had more dysphagia compared with their controls. They consumed lower amounts of fluid and solid food on both investigated occasions, compared with their controls. Multiple regression analysis showed that weight loss was associated with female gender, eating difficulties related to activities of daily living and preference towards soft food, but negatively correlated with age.

Conclusion.  Parkinson's disease patients with weight loss seemed to avoid solid food, partly because of eating difficulties. Eating problems, as well as weight loss, could be because of the underlying disease, even when it is not at an advanced stage.

Relevance to clinical practice.  Caring for patients with Parkinson's disease should not only include medical treatment, but also support for adequate food intake to prevent weight loss.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35214 (URN)10.1111/j.1365-2702.2005.01454.x (DOI)25685 (Local ID)25685 (Archive number)25685 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2012-09-28Bibliographically approved

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