Weight loss and weight gain in Parkinson disease

Ghourchian, Shadi; Gruber‐Baldini, Ann L.; Shakya, Sunita; Herndon, John S.; Reich, Stephen G.; Coelln, Rainer von; Savitt, Joseph M.; Shulman, Lisa M.

doi:10.1016/j.parkreldis.2020.12.018

Cited by 13 publications

(11 citation statements)

References 20 publications

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“…12,13 By contrast, another study revealed that weight loss was not related to MMSE score changes over a 2-year period. 6 However, these results were limited because of a low number of participants (n = 23) 12 or retrospective data collection with relatively short follow-up periods. 6,13 Furthermore, the MMSE used in those studies is unlikely to be sensitive enough to detect early cognitive impairment in patients with PD.…”

Section: Discussionmentioning

confidence: 99%

“…6 However, these results were limited because of a low number of participants (n = 23) 12 or retrospective data collection with relatively short follow-up periods. 6,13 Furthermore, the MMSE used in those studies is unlikely to be sensitive enough to detect early cognitive impairment in patients with PD. 24 Thus, our findings may provide more reliable evidence that early weight loss in patients with PD could serve as a surrogate biomarker for patients at risk of cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

“…However, a recent study suggests that 3% weight change is better predictive of PD impairment and disability than 5% weight change. 6 Accordingly, we primarily defined early weight loss as a >3% decrease in body weight from baseline to 1 year, weight maintenance as a weight change of less than ±3%, and early weight gain as a >3% increase in weight in this study. To test sensitivity to different cut-off values, we also performed additional analyses using a 5% cutoff.…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

“…5 A more recent study including 668 patients with early to advanced PD found that weight gain of at least 3% occurred in 154 (23%) patients over 2 years and weight gain of at least 5% occurred in 105 (16%) patients. 6 Although associations of both weight loss and weight gain with subsequent dementia in older populations have been reported in many epidemiologic studies, [7][8][9][10][11] the evidence connecting early weight change and cognitive decline in patients with PD is still lacking. Two previous studies showed that weight loss was associated with a faster decline in global cognition in patients with PD, but these results were based on a small number of patients or retrospective study designs with limited followup.…”

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confidence: 99%

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Association of Early Weight Change With Cognitive Decline in Patients With Parkinson Disease

Kim¹,

Choi²,

Byun³

et al. 2023

Neurology

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Background and objective:To examine whether early weight change is associated with subsequent deterioration in cognitive function, including overall performance and specific domains, in Parkinson’s disease (PD).Methods:This observational study used data from the Parkinson’s Progression Markers Initiative cohort. The patients underwent annual non-motor assessments covering neuropsychiatric, sleep-related, and autonomic symptoms for up to 8 years of follow-up. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) and detailed neuropsychological testing. Linear mixed-effects models were applied to investigate the association of early weight change with longitudinal evolution of cognitive and other non-motor symptoms.Results:A total of 358 early PD patients were classified into weight loss (decrease of >3% body weight during the first year; n=98), weight maintenance (within ±3%; n=201), and weight gain (increase of >3%; n=59) groups. The weight loss group showed a significantly faster decline in MoCA scores than the weight maintenance group (β=−0.19, 95% confidence interval [CI] −0.28 to −0.10). With respect to specific cognitive domains, the weight loss group showed a steeper decline in sematic fluency test scores (β=−0.37, 95% CI −0.66 to −0.08) and MoCA phonemic fluency scores (β=−0.18, 95% CI −0.31 to −0.05) and, to a lesser extent, Letter-Number Sequencing scores (β=−0.07, 95% CI −0.14 to 0.01) compared to the weight maintenance group. Conversely, the weight gain group showed a slower decline in the Symbol-Digit Modalities Test scores (β=0.34, 95% CI 0.05 to 0.63), although no association was found with longitudinal changes in MoCA scores. We did not find any significant effects of weight change on the progression of other non-motor symptoms.Discussion:Early weight loss was associated with a faster progression of decline in global cognitive function and executive function in PD patients, whereas early weight gain was associated with a slower progression of decline in processing speed and attention. The impact of early weight change on non-motor symptoms appeared to be specific to cognition.

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