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Nutritionsstatus och viktförändring vid Parkinsons sjukdom
Kristianstad University, School of Health and Society. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Lunds universitet.ORCID iD: 0000-0001-6618-2116
2015 (Swedish)Licentiate thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Malmö: Institutionen för kliniska vetenskaper, Malmö, Lund universitet , 2015. , 77 p.
Keyword [sv]
Parkinson, nutrition, viktförändring
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hkr:diva-16230OAI: oai:DiVA.org:hkr-16230DiVA: diva2:1046989
Presentation
2015-11-24, Malmö, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2016-11-16 Created: 2016-11-14 Last updated: 2016-11-17Bibliographically approved
List of papers
1. Weight stability in Parkinson's disease
Open this publication in new window or tab >>Weight stability in Parkinson's disease
2016 (English)In: Nutritional neuroscience, ISSN 1028-415X, E-ISSN 1476-8305, Vol. 19, no 1, 11-20 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Parkinson's disease (PD) has traditionally been associated with weight loss. However, recent studies have not found any evidence of underweight in PD. Nevertheless, few studies have addressed nutritional status changes over time in relation to other clinical PD features. Here, we explore changes in nutritional status and motor and non-motor PD features (including dopaminergic drug therapy) in PD patients after 1 year. Methods: Motor and non-motor PD features, dopaminergic drug therapy, under-nutrition and malnutrition risk, and anthropometric measures (BMI, handgrip strength, triceps skin-fold, mid-arm circumference, and mid-upper arm muscle circumference) were assessed at baseline and 1 year later among 65 people with PD. Results: Disability, PD motor symptoms, dysautonomia, and dopaminergic drug therapy increased. Underweight was uncommon both at baseline (n= 3) and follow-up (n = 2); malnutrition risk was common but stable (88 and 92%), whereas triceps skin-fold increased (P = 0.030); mid-upper arm muscle circumference decreased (P = 0.002); and the proportion of people with low handgrip strength (P = 0.012) increased. Correlations between nutritional variables and motor and non-motor PD features were absent to modest. Multiple linear regression analysis showed that baseline pupillomotor functioning was associated with decreased weight and BMI, and sleep with increased weight and BMI. In addition, increases in anxiety were associated with decreased weight, BMI, and triceps skin-fold. Discussion: During the PD course, there seems to be redistribution in body composition from muscle to fat. Studies are needed to identify possible explanations for the findings. This implies that malnutrition should be regularly screened to identify those at risk of developing reduced muscle mass and increased morbidity.

Keyword
Parkinson's disease, weight, body composition, nutrition, protein intake
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-15258 (URN)10.1179/1476830515Y.0000000044 (DOI)000368260800002 ()26339843 (PubMedID)
Available from: 2016-02-05 Created: 2016-02-05 Last updated: 2017-01-11Bibliographically approved
2. Malnutrition risk in Parkinson's disease
Open this publication in new window or tab >>Malnutrition risk in Parkinson's disease
2014 (English)In: Journal of Aging Research & Clinical Practice, ISSN 2258-8094, Vol. 3, no 2, 93-99 p.Article in journal (Refereed) Published
Abstract [en]

Background: Unintentional weight loss and undernutrition have been found common in  Parkinson’s disease but its relation to other disease aspects is unclear.

Objectives: To explore nutritional status in relation to disease duration in Parkinson’s disease, as well as associations between nutritional status and motor and autonomic features.

Design: Cross-sectional.

Setting: South-Swedish outpatient Parkinson-clinic.

Participants: Home-dwelling people with Parkinson’s disease (n=71), without significant cognitive impairment (mean age, 67.3 years; 56% men; mean disease duration, 6.3 years).

Measurements: Parkinsonian motor symptoms, mobility, activity level, disability, dyskinesias, dysautonomia, under- and malnutrition risk screening (using MEONF II and MUST for undernutrition and SCREEN II for malnutrition) and anthropometric measures (BMI, handgrip strength, triceps skin-fold, mid-arm circumference and mid-upper arm muscle circumference) were recorded. The sample was divided into those with longer (n=34) and shorter disease duration (n=37) according to the median (5 years).

Results: Longer disease duration was associated with more, disability, dyskinesias and dysautonomia than shorter duration (P ≤0.04). Mean (SD) body weight and BMI were 80.3 (16.3) kg and 28.1 (4.8) kg/m 2, respectively, and did not differ between duration groups (body weight, 80.9 vs. 79.6 kg; BMI, 28.0 vs. 28.3 kg/m 2; P≥0.738). There were no differences in other anthropometric measures between duration groups (P ≥0.300). BMI identified 4% and 62% as under- and overweight, respectively, and 4% exhibited  undernutrition risk, whereas 87% were at risk for malnutrition. Nutritional and motor/dysautonomic variables showed relatively weak correlations (r s, ≤ 0.33), but people with orthostatic hypotension had lower BMI (26.7 vs 29.2 kg/m 2; P=0.026) and lower handgrip strength (33.2 vs 41.6 kg; P=0.025) than those without orthostatic hypotension.

Conclusion: Motor and autonomic features showed expected relationships with disease duration. In contrast to these observations, and to most previous reports on nutrition in PD, frequencies of underweight and undernutrition were low. However, malnutrition risk was high, emphasizing the need for regular clinical monitoring of nutritional status. The reasons for the preserved nutritional status have to be explored prospectively.

Keyword
duration, nutrition, parkinson's disease, weight
National Category
Nursing
Identifiers
urn:nbn:se:hkr:diva-12794 (URN)
Projects
Ofrivillig viktförändring vid Parkinson's disease
Available from: 2014-09-02 Created: 2014-09-02 Last updated: 2016-11-16Bibliographically approved

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