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Avoidance of solid food in weight losing older patients with Parkinson's disease
Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
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.

Place, publisher, year, edition, pages
2006. Vol. 15, no 11, 1404-1412 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-35214DOI: 10.1111/j.1365-2702.2005.01454.xLocal ID: 25685OAI: oai:DiVA.org:liu-35214DiVA: diva2:256062
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2012-09-28Bibliographically approved
In thesis
1. Weight loss in elderly patients with Parkinson's disease
Open this publication in new window or tab >>Weight loss in elderly patients with Parkinson's disease
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:nbn:se:liu:diva-33457 (URN)19478 (Local ID)91-85299-10-3 (ISBN)19478 (Archive number)19478 (OAI)
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

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Lorefält, BirgittaGranerus, Ann-KathrineUnosson, Mitra

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