Objective: To quantify and assess weight loss in older patients with PD attending a Movement disorders clinic

Background: Patients with Parkinson’s disease often lose weight due to a combination of calorific deficit (poor oral intake due to anosmia, dysphagia , constipation) or increased energy expenditure (rigidity, tremor,  dyskinesia). Weight loss can predate the diagnosis and may worsen with disease progression and cognitive impairment. Other causes of weight loss including malignancy, thyroid disease and depression should be considered.

Methods: Patients attending the clinic over a 6 month period in 2016 were identified by the electronic patient recording system. Data was recorded in a proforma and then exported to an excel sheet for analysis. Patients with Vascular Parkinsonism (VP), single clinic attendance and in whom documentation of weight recordings were missing were excluded. Any change in body weight from previous clinic attendance was recorded.

Results: 142 patients attended the clinic. Data for 118 patients was analysed, exclusions included 2 patients with VP, 11 single attendances and missing data for 11 patients. 68 (58%) were male and the average age was 81.8yrs (64 -95yrs). The average duration of PD was 7yrs (0.5 – 34 yrs) whilst the average duration between clinic appointments was 9.8 months. 32 (27%) had dementia.

Weight loss was documented in 58 (49%) of patients and the average weight loss was 0.58kg/month (range 0.03 – 2.5). 25(21%) had swallowing difficulties and all of them (100%) were referred to speech and language therapists for assessment and advice. 5 patients were referred to dietician whilst 4 patients had investigations to exclude other causes of weight loss.

Conclusions: Our study demonstrates that weight loss is common in Parkinson’s disease.1 The aetiology of weight loss needs to be explored in individual cases .Speech and language assessment and recommendation for food consistency should be initiated early in patients with swallowing difficulties complemented with advice from dietician regarding calorie intake. Clinicians need to be vigilant to exclude other causes of weight loss.

References:

1. Lorefalt B, Ganowiak W, Palhagen S, Toss G, Unosson M, Granerus AK. Factors of importance for weight loss in elderly patients with Parkinson’s disease. Acta neurologica Scandinavica. 2004; 110(3):180–7

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MDS Abstracts - https://www.mdsabstracts.org/abstract/weight-loss-in-parkinsons-disease-pd/