Early weight loss in parkinsonism predicts poor outcomes

Abstract

Objective:To compare weight change over time in patients with Parkinson disease (PD), those with atypical parkinsonism, and matched controls; to identify baseline factors that influence weight loss in parkinsonism; and to examine whether it predicts poor outcome.Methods:We analyzed data from the Parkinsonism Incidence in North-East Scotland (PINE) study, an incident, population-based prospective cohort of parkinsonian patients and age- and sex-matched controls with annual follow-up. Mixed-model analysis described weight change in patients with PD, those with atypical parkinsonism, and controls. Baseline determinants of sustained clinically significant weight loss (>5% loss from baseline) and associations between early sustained weight loss and death, dementia, and dependency in parkinsonism were studied with Cox regression.Results:A total of 515 participants (240 controls, 187 with PD, 88 with atypical parkinsonism) were followed up for a median of 5 years. At diagnosis, atypical parkinsonian patients had lower body weights than patients with PD, who were lighter than controls. Patients with PD lost weight more rapidly than controls, and weight loss was most rapid in atypical parkinsonism. After multivariable adjustment for potential confounders, only age was independently associated with sustained clinically significant weight loss (hazard ratio [HR] for 10-year age increase 1.83, 95% confidence interval [CI] 1.44–2.32). Weight loss occurring within 1 year of diagnosis was independently associated with increased risk of dependency (HR 2.11, 95% CI 1.00–4.42), dementia (HR 3.23, 95% CI 1.40–7.44), and death (HR 2.23, 95% CI 1.46–3.41).Conclusion:Weight loss occurs in early parkinsonism and is greater in atypical parkinsonism than in PD. Early weight loss in parkinsonism has prognostic significance, and targeted dietary interventions to prevent it may improve long-term outcomes.

Propolis as a Potential Disease-Modifying Strategy in Parkinson’s disease: Cardioprotective and Neuroprotective Effects in the 6-OHDA Rat Model

“…Unintentional weight loss attributed to PD is frequent and linked to worse quality of life in patients [ 107 , 108 ]. Reduced calorie consumption and increased energy expenditure have been suggested as the undesirable cause of weight loss in PD [ 109 , 110 , 111 ]. A recent study assessed the association between dysautonomia and body weight in PD subjects by the investigation of parasympathetic dysfunction (HRV measurement and the existence of constipation) and sympathetic denervation (orthostatic hypotension and cardiac uptake of 123 I–metaiodobenzylguanidine ( 123 I-MIBG)) [ 110 ].…”

Mitochondrial Creatine Kinase is Decreased in the Serum of Idiopathic Parkinson’s Disease Patients

“…In our study, the drug Medopa did not notably affect serum uMtCK activities. Another manifestation of PD is weight change [34, 35], and taking this into consideration, we also analyzed the relationship between BMI and sMtCK activities. However, we found no significant correlation.…”

Is systolic blood pressure decrease with age in patients with Parkinson's disease?

“…In the general population, body weight increases with age and this may explain partially the BP increase observed with aging 4 . Patients with PD may lose weight with aging 5 . Weight loss may explain the decrease in systolic BP with aging observed by Shindo et al 1 Unfortunately, the weights were not reported in the study, and therefore, this possibility cannot be confirmed.…”