Nutritional Status Associated with Molecular Biomarkers, Physiological Indices, and Clinical Severity in Parkinson’s Disease Patients

This study is intended to explore the associations between nutritional status and molecular biomarkers and the clinical severity of Parkinson’s disease (PD), as well as to examine the differences in related factors between PD patients with normal nutrition and those with at risk for malnutrition. A cross-sectional assessment of 82 consecutive outpatients with PD was conducted using the mini nutritional assessment (MNA), Unified Parkinson’s Disease Rating Scale (UPDRS), and the Hoehn and Yahr scale to determine the nutritional status, the clinical severity of PD, and the stage of the disease. Recordings of blood samples collected after 12 h of overnight fasting were also assessed in terms of serum levels of glycated hemoglobin (HbA1c), blood urea nitrogen (BUN), creatinine, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), hemoglobin (Hgb), folate, and vitamin B12. All participants were divided into normal nutrition and malnutrition risk groups via the MNA scores to compare the above-mentioned parameters. The results showed that the total MNA score was significantly correlated with some parts of the UPDRS scale (e.g., Sections 1 and 2) and the levels of HbAlc in PD patients and those with risk for malnutrition, with significantly lower weight and body mass index (BMI), and with lower levels of Hgb and HDL. Higher levels of cholesterol were observed in the malnutrition risk group as compared with the normal nutrition group. The findings suggest that the clinical severity of PD is associated with nutritional status. Body weight, BMI, and the levels of Hgb, cholesterol, and HDL could be, at least partially, important biological markers to monitor malnutrition and the progression of the disease.

Download Full-text

Nutritional assessment in patients with Parkinson’s disease: The nutri-park study

Nutrition and Healthy Aging ◽

10.3233/nha-200083 ◽

2020 ◽

Vol 5 (4) ◽

pp. 297-305

Author(s):

S. Gatti ◽

M. Carugi ◽

V. Palermo ◽

C. Casellato ◽

C. Gambini ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Nutritional Status ◽

Dietary Habits ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Inverse Correlation ◽

Bioelectrical Impedance ◽

Impedance Analysis ◽

Protein Distribution

BACKGROUND: Several studies have found a link between nutritional status and neurodegenerative diseases, such as Parkinson’s disease (PD). OBJECTIVE: The aim of our study was to assess both nutritional status and dietary habits of PD patients with respect to controls and to compare disease progression in relation to dietary habits, such as protein distribution diet (PRD) adherence. METHODS: We collected anthropometric measurements, Mini Nutritional Assessment (MNA) score, dietary habits, micro- and macronutrients intakes, body composition by Bioelectrical Impedance Analysis (BIA), muscle strength and gait speed of 66 PD patients and 58 controls (40 healthy controls and 18 subjects with essential tremor). Clinical scales and progression indexes were recorded in PD group. RESULTS: No significant differences emerged between PD and controls in anthropometric and BIA measurements; a comparable dietary intake between the two groups was recorded. Sarcopenia and dynapenia were comparable between the two groups. PD resulted more at risk of malnutrition than controls to MNA, only three patients and one control were malnourished. A notable inverse correlation was observed between MNA and PD Questionnaire 8. PD following a PRD showed a slower progression index. CONCLUSION: Nutritional status of PD patients is not so different from elderly controls. PRD is recommended for patients with PD.

Download Full-text

Nutritional Status and Cardiometabolic Risk Factors in Institutionalized Adults with Cerebral Palsy

Medicina ◽

10.3390/medicina55050157 ◽

2019 ◽

Vol 55 (5) ◽

pp. 157 ◽

Cited By ~ 1

Author(s):

Aurora Norte ◽

Coral Alonso ◽

José Miguel Martínez-Sanz ◽

Ana Gutierrez-Hervas ◽

Isabel Sospedra

Keyword(s):

Risk Factors ◽

At Risk ◽

Cerebral Palsy ◽

Nutritional Status ◽

Cardiometabolic Risk ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Density Lipoprotein ◽

Cardiometabolic Risk Factors ◽

Lipoprotein Cholesterol

Background and Objectives: Cerebral palsy (CP) is a set of permanent disorders that limit physical activity and increase the risk of developing other diseases, such as metabolic syndrome (MS). Adequate nutrition can contribute to the prevention of associated symptoms. The main objective of this study is to evaluate the nutritional status and the prevalence of cardiometabolic risk factors in adults with CP and Gross Motor Function Classification System (GMFCS) levels between IV and V. Materials and Methods: A sample of 41 adults with CP and GMFCS levels from IV to V were studied. The variables used in the study were age, sex, weight, height, mean age, and GMFCS level range. To evaluate nutritional status, body mass index and the Mini Nutritional Assessment (MNA), a nutritional screening tool, were used. To assess cardiometabolic risk, data on obesity, central obesity, blood pressure, fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were collected. Results: More than 80% of the population studied was malnourished or at risk of malnutrition, according to the MNA tool classification ranges, and around 35% of the studied population was within the underweight range. Regarding cardiometabolic risk factors, only one adult with CP was diagnosed with MS. Conclusions: The studied population of adults with CP and GMFCS levels between IV and V is not a population at risk of MS; however, the high prevalence of malnutrition, as well as some of the most prevalent cardiovascular risk factors, should be taken into consideration.

Download Full-text

Parkinson's disease: Impact of clinical and cognitive aspects on quality of life

Dementia & Neuropsychologia ◽

10.1590/s1980-57642010dn40200010 ◽

2010 ◽

Vol 4 (2) ◽

pp. 131-137 ◽

Cited By ~ 7

Author(s):

Glória Maria Almeida Souza Tedrus ◽

Lineu Correa Fonseca ◽

Patrícia Mencaroni Kange

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Signs And Symptoms ◽

Well Being ◽

Maternity Hospital ◽

Related Factors ◽

Significance Level

Abstract Parkinson's disease (PD) is a chronic disease manifested principally by motor signs and symptoms, but with frequent neuropsychological alterations. Objectives: To study the relationship between clinical and cognitive aspects and the perception of quality of life (QOL) in PD patients. Methods: Twenty consecutive patients (13 men) with idiopathic PD (mean age: 64.5y), mean disease time of 7.8 years and at stages 1-3 according to the modified Hoehn and Yahr staging scale (HYS), all outpatients from the Neurology Department of the Celso Pierro General and Maternity Hospital (PUC-Campinas), were analyzed. The following were applied: a clinical-neurological assessment, the Mini-Mental State Examination (MMSE), standard neuropsychological battery of the CERAD (Consortium to Establish a Registry for Alzheimer's Disease), Hamilton Depression Rating Scale (HAM-D) and a QOL questionnaire (Parkinson's Disease Questionnaire - PDQ-39). Statistical analysis was carried out at a significance level of p<0.05. Results: On the PDQ-39 under the sections total, mobility and activities of daily living, and the items motor compromise (HYS) and language of the MMSE were predictors of worse QOL. Verbal fluency was a factor for emotional well-being on the PDQ-39, whereas higher scores for HAM-D and worse performance on the item attention and calculation of the MMSE were associated with worse QOL in the social support section. Total score on the MMSE and educational level were QOL factors in cognition Conclusions: The findings of the present study suggest that clinical, cognitive, motor or other depression-related factors contribute differently to the domains of QOL.

Download Full-text

EARLY RECOGNITION OF COGNITIVE ABILITY AND NUTRITIONAL MARKERS FOR DEMENTIA IN PARKINSON’S DISEASE

Journal of Aging Research and Lifestyle ◽

10.14283/jarcp.2018.26 ◽

2018 ◽

pp. 1-7

Author(s):

L. Håglin ◽

L. Bäckman ◽

J. Linder ◽

L. Forsgren ◽

M. Domellöf

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Nutritional Status ◽

Cognitive Decline ◽

Iron Homeostasis ◽

Rating Scale ◽

Cox Regression ◽

Nutritional Deficiencies ◽

Iron Intake

Background: Cognitive decline and dementia are common non-motor problems in Parkinson’s disease (PD). The underlying aetiology is multifaceted and both chronic and reversible causes for cognitive decline are likely to be present. Malnutrition is frequent in the Parkinson population, both early and late in the disease, and nutritional deficiencies could play a role in some cognitive deficits. Objectives: The objective is to study the association between nutritional status with focus on iron intake and homeostasis, mild cognitive impairment (MCI), and PD dementia (PDD). Setting and Participants: This study included 73 out of 145 patients with PD participating in a population-based study in northern Sweden. Measurements: Registration of nutritional status by laboratory analyses of blood plasma and neuropsychological assessments at time of diagnosis were performed. MCI and PDD were assessed yearly up to ten years after diagnosis. Mini Nutritional Assessments (Full-MNA score) and plasma variables detecting iron homeostasis were compared between patients with MCI and patients with normal cognition (NC). Motor severity was measured using the Unified Parkinson´s disease rating scale III, (UPDRS III) and Hoehn and Yahr (H&Y) staging scale. Cox proportional Hazard model were performed to see if any variables that differed between MCI and NC could predict PDD at follow-up. Results: Patients with MCI at time of diagnosis had lower levels of plasma iron (P-Fe) and albumin (P-Albumin) as well as a lower score on Full-MNA score. Dietary intake of iron was higher in patients with MCI than in patients with NC (p = 0.012). In logistic regression models adjusted for age, sex, and UPDRS III, lower levels of P-Fe (p = 0.025) and P-Albumin (p = 0.011) and higher dietary iron intake (p = 0.019) were associated with MCI at baseline. A Cox regression model with dementia as endpoint revealed that lower levels of P-Fe increase the risk of dementia at follow-up with adjustments for age, sex, UPDRS III, and MCI at baseline (HR 95% CI = 0.87 (0.78-0.98), p = 0.021). Conclusions: Low P-Fe was associated with cognitive disturbance at baseline and predicted dementia up to ten years after diagnosis in patients with PD. Low P-Albumin and malnutrition assessed with Full-MNA score were associated with MCI at baseline but did not predict dementia at follow-up.

Download Full-text

Malnutrition and related factors in Filipino patients with Parkinson’s disease: results from a pilot study

Neurodegenerative Disease Management ◽

10.2217/nmt-2020-0050 ◽

2021 ◽

Author(s):

Nikolai Gil D Reyes ◽

Roland Dominic G Jamora ◽

Marianne Rae M Baltazar ◽

Alfand Marl F Dy Closas

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Nutritional Status ◽

Associated Factors ◽

The Body ◽

Related Factors ◽

Bidirectional Relationship ◽

Daily Dose ◽

The Mean ◽

Levodopa Equivalent Daily Dose

Aim: Emerging evidence demonstrates a bidirectional relationship between nutritional status and Parkinson’s disease (PD). Our aim was to determine the local prevalence of malnutrition and associated factors among Filipino PD patients. Materials & methods: We assessed the nutritional status of 95 PD patients using the body mass index (BMI) and Subjective Global Assessment (SGA) and identified malnutrition-associated factors. Results & conclusion: In our sample, the mean BMI was 24.5 ± 4.2 kg/m2. Consistent with published estimates, five (5.3%) patients were classified as underweight and 57 (60%) patients were classified as overweight/obese. A total of 30 (31.6%) patients had abnormal nutritional status based on SGA. Weight-adjusted levodopa equivalent daily dose was a significant factor (p = 0.032) for BMI, while dysphagia and higher weight-adjusted levodopa equivalent daily dose were found to be predictive of abnormal nutritional status using SGA (adjusted odds ratio of 8.85 [95% CI: 1.59–49.17; p = 0.015] and 1.10 [95% CI: 1.02–1.20; p = 0.021], respectively).

Download Full-text

The Mini Nutritional Assessment (MNA) and applications to Parkinson's disease

Genetics, Neurology, Behavior, and Diet in Parkinson's Disease ◽

10.1016/b978-0-12-815950-7.00038-2 ◽

2020 ◽

pp. 597-608

Author(s):

Svetlana Tomic

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Nutritional Assessment ◽

Mini Nutritional Assessment

Download Full-text

Mini Nutritional Assessment in patients with Parkinson's disease: correlation between worsening of the malnutrition and increasing number of disease-years

Nutritional Neuroscience ◽

10.1179/147683008x301441 ◽

2008 ◽

Vol 11 (3) ◽

pp. 128-134 ◽

Cited By ~ 34

Author(s):

Michela Barichella ◽

Maria Chiara Villa ◽

Arianna Massarotto ◽

Sara Elisabetta Cordara ◽

Agnieszka Marczewska ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Nutritional Assessment ◽

Mini Nutritional Assessment

Download Full-text

ETHNIC DISPARITY IN NUTRITIONAL STATUS: EVIDENCE FROM ECUADOR’S NATIONAL SURVEY OF HEALTH, WELFARE AND AGING (SABE)

Innovation in Aging ◽

10.1093/geroni/igz038.927 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S247-S247

Author(s):

Takashi Amano ◽

Carlos Andres Gallegos

Keyword(s):

Older Adults ◽

Ethnic Identity ◽

Nutritional Status ◽

Indigenous People ◽

Nutritional Assessment ◽

Population Aging ◽

Economic Status ◽

Public Investment ◽

Mini Nutritional Assessment ◽

Related Factors

Abstract Providing effective public services to improve the nutritional status among older adults is pivotal in countries experiencing population aging. Public investment and social policy in Ecuador have focused mainly on standard food-based interventions and cash transference programs. These efforts, however, may be not effective enough to reach those populations that need the most. This study aims to identify those populations that should be targeted by specific interventions. Data were drawn from Ecuador’s Survey of Health, Welfare and Aging (SABE) – 2009, a probability sample of households with at least one person who were 60 years or older in Ecuador. The final sample consisted of 5,235 people who were 60 years or older. Ethnic identity was categorized into four categories: Indigenous People, Mestizo (Mixed of Spanish and Indigenous People), Afro-Ecuadorian/Mulato, and Other. Nutritional status was measured using Mini Nutritional Assessment (MNA). Ordered logistic regression analysis was utilized to assess the association between ethnic identity and nutritional status. Results revealed that the Indigenous ethnicity was significantly associated with worse nutritional status compared to Mestizo and Other even after controlling for a range of covariates including socio-economic status, health related factors, and social support. These findings suggest the existence of underlaying factors hindering the nutritional status of among indigenous older adults in Ecuador. Considering the information revealed by SABE, interventions and other strategies should be targeted and designed specifically accounting for the needs, preferences, and culture of the most vulnerable population.

Download Full-text

Predicting Longitudinal Disease Severity for Individuals with Parkinson’s Disease using Functional MRI and Machine Learning Prognostic Models

10.1101/2020.04.20.050971 ◽

2020 ◽

Author(s):

Kevin P. Nguyen ◽

Vyom Raval ◽

Alex Treacher ◽

Cooper Mellema ◽

Frank Yu ◽

...

Keyword(s):

Machine Learning ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Severity ◽

Clinical Decision Making ◽

Rating Scale ◽

Neurodegenerative Disorder ◽

Clinical Severity ◽

Predictive Values ◽

Updrs Score

AbstractParkinson’s disease is the second most common neurodegenerative disorder and is characterized by the loss of ability to control voluntary movements. Predictive biomarkers of progression in Parkinson’s Disease are urgently needed to expedite the development of neuroprotective treatments and facilitate discussions about disease prognosis between clinicians and patients. Resting-state functional magnetic resonance imaging (rs-fMRI) shows promise in predicting progression, with derived measures, including regional homogeneity (ReHo) and fractional amplitude of low frequency fluctuations (fALFF), having been previously been associated with current disease severity. In this work, ReHo and fALFF features from 82 Parkinson’s Disease subjects are used to train machine learning predictors of baseline clinical severity and progression at 1 year, 2 years, and 4 years follow-up as measured by the Movement Disorder Society Unified Depression Rating Scale (MDS-UPDRS) score. This is the first time that rs-fMRI and machine learning have been combined to predict future disease progression. The machine learning models explain up to 30.4% (R2 = 0.304) of the variance in baseline MDS-UPDRS scores, 55.8% (R2 = 0.558) of the variance in year 1 scores, and 47.1% (R2 = 0.471) of the variance in year 2 scores with high statistical significance (p < 0.0001). For distinguishing high- and low-progression individuals (MDS-UPDRS score above or below the median), the models achieve positive predictive values of up to 71% and negative predictive values of up to 84%. The models learn patterns of ReHo and fALFF measures that predict better and worse prognoses. Higher ReHo and fALFF in regions of the default motor network predicted lower current severity and lower future progression. The rs-fMRI features in the temporal lobe, limbic system, and motor cortex were also identified as predictors. These results present a potential neuroimaging biomarker that accurately predicts progression, which may be useful as a clinical decision-making tool and in future trials of neuroprotective treatments.

Download Full-text