Prevalence of malnutrition in Parkinson's disease and correlation with gastrointestinal symptoms

Abstract

Background:Parkinson's disease (PD) patients are at a higher risk of malnutrition with the overall prevalence estimated to be 3%–60%, but there are limited data in India regarding nutritional assessment of PD.Aim:This study aims to assess nutritional status of PD patients and correlate the disease factors and gastrointestinal tract (GIT) symptoms with nutritional status.Materials and Methods:The PD cohort was assessed for demographic factors, nutritional assessment was done by Mini-Nutritional Assessment (MNA) Scale, and GI symptoms were assessed by validated scales. Age- and gender-matched cohort controls were randomly selected to correlate the GIT symptoms influencing nutritional status. The study population was divided into two groups according to the MNA score; Group I malnourished/at risk of malnutrition (score <23.5) or Group II normal nutrition (>23.5). The two subgroups were then compared.Results:We assessed 75 patients of PD and 35 age- and gender-matched controls. According to anthropometric criteria, 23% of the PD population was underweight, and according to biochemical assessment, 17.3% had hypoalbuminemia along with anemia. According to MNA scale, 12% were malnourished and 45.3% were at risk of malnutrition. Hence, a total of 57.3% patients in Group I (with abnormal nutrition) as compared to 14% of the controls were at risk of malnutrition while none was found to be malnourished. In our study, GIT symptoms, such as sialorrhea and dysphagia was reported by 29.3% each and constipation by 41.3% patients. While comparing GI symptoms within the two MNA groups, there was statistically significant relationship of all GI manifestations, sialorrhea (P = 0.041), dysphagia (P = 0.00081), and constipation (P = 0.0042) with malnutrition. There was no statistical significant difference between groups for age (P = 0.54), gender (P = 0.903), and duration of disease (P = 0.743).Conclusions:The data suggest that about 45% of PD patients are at risk of malnourishment. MNA Score is a validated nutritional assessment tool and anthropometric or biochemical measures alone cannot identify all the malnourished population. PD patients at risk of malnutrition or malnourished do have symptoms of dysphagia, sialorrhea, and constipation as compared to PD patients with normal nutrition.

Constipation and Its Associated Factors among Patients with Dementia

“…MNA is a questionnaire used for whole-body health evaluation, including body weight change, appetite, and body figure. In our study, we found that patients at risk of malnutrition according to their MNA scores were also at risk of constipation, and this finding was similar to what was reported for those with Parkinson' s disease [30].…”

Clinical Study of Thirty Patients with Parkinson Disease and Associated Pathology

“…Several studies have observed that PD patients generally suffer from gastrointestinal disorders and GM dysbiosis prior to displaying motor symptoms [40][41][42][43]. In addition, we have found in the patients examined dysphagia and swallowing disturbances.…”

Autonomic Dysfunction in Parkinson's Disease

“…Although more likely to be present in patients with advanced PD, dysphagia may develop early in the course of PD [61]. Dysphagia increases the risk of malnourishment and malnutrition in patients with PD [62], and dysphagia severity predicts a poor outcome in persons with advanced PD [63]. Dysphagia for pills is an often overlooked aspect of dysphagia in PD and may be evident in close to 30% of patients, particularly those with more advanced disease [64].…”