Is Malnutrition an Issue?

Tuesday September 16, 2014

 - A report recently published in the Journal of Parkinson’s Disease concludes that people with Parkinson’s disease can experience difficulty with both food preparation and ingestion, which in turn can lead to problems of poor nutrition and possibly malnutrition. However, from another study, researchers disagree, stating that there is no greater risk for malnutrition in people with mild to moderate cases of the disease than for the healthy general population.

While there is some controversy over the report published in the Journal of Parkinson’s Disease, researchers do agree that that many Parkinson’s patients are underweight. The lead author of this latest study, Dr. Seyed-Mohammad Fereshtehnejad with the Division of Clinical Geriatrics of the Department of Neurobiology, Care Sciences, and Society at Sweden’s Karolinska Institute Hospital, says that there is evidence of increased risk of malnutrition for people with mild to moderate cases of Parkinson’s disease compared to and healthy control subjects.

Dr. Seyed-Mohammad adds that there are a number of factors associated with poor nutrition in Parkinson’s disease patients to include difficulty in cutting and bringing food to the mouth, as well as chewing and swallowing. Appetite may also decrease because of depression and constipation, two things commonly associated with the disease.

This study was designed to determine if these patients are malnourished. To make that determination, two groups of people from Iran were studied, one consisting of 143 patients with mild to moderate Parkinson’s and the other of 145 patients of the same gender and age used as the control group. Excluded from the study were Parkinson’s patients suffering a chronic condition that would affect nutrition to include diabetes and hypertension, as well as those on a special diet or showing cognitive impairment.

Using the Persian version of the Mini Nutritional Assessment (MNA) questionnaire, the nutritional status of participants was evaluated. Participants were asked to answer 18 questions pertaining to dietary issues, appetite, nutrition, malnutrition, feeding, and self-perception of health during 10 to 15 minute interviews and BMI, weight loss, and arm/calf circumferences were assessed.

The MNA helps to determine level of nutrition, with the highest score being 30. From there, 24-30 indicates healthy nutrition, 17 to 23.5 a risk for malnutrition, and less than 17, existing malnutrition. Using the MNA, researchers could not find any significant difference between the two groups for the highest score. However, 2.1% of Parkinson’s patients scored less than 17, showing malnutrition while 25.9% were in the 17 to 23.5 range, thereby being at risk of malnutrition.

Interestingly, on some measures, the patients with Parkinson’s disease did better than participants in the controlled group specific to psychological stress, weight loss, consumption of fresh fruits and vegetables, and protein intake although arm/calf circumference was dramatically lower in the patients with Parkinson’s.

The information gathered from the study shows that approximately 30% of patients with mild to moderate Parkinson’s disease are at risk for malnutrition. As far as the low incidence of risk specific to severe Parkinson’s, Dr. John Lokk, lead investigator with the Department of Geriatric Medicine of Sweden’s Karolinska University Hospital, said the study’s outcome could be the result of the patients selected for the study.

He goes on to say that participants of the study were recruited from an outpatient clinic and therefore, hospitalized patients with a more debilitating case of Parkinson’s were not included. He strongly believes that if this latest study had included people with severe Parkinson’s disease, risk of malnutrition would be significantly higher.

http://www.newsonwellness.com/2014/09/higher-risk-malnutrition-found-parkinsons-patients/