Blog: links between weight loss and dependency for basic daily activities in people with Parkinson’s

I have frequently seen people with Parkinson’s lose substantial amounts of weight and wondered why this happens and what effects it might have. Our study investigated what were the consequences of weight loss in Parkinson’s and atypical parkinsonism. You can read the full study on in the journal Neurology.
 
We studied a cohort of 275 people with Parkinson’s disease and other forms of parkinsonism, part of the PINE study, an incident cohort designed to study the prognosis in all new cases of parkinsonism in the Aberdeen area from a 4.5 year period. We measured their weights every year for up to 12 years.

We recorded whether the people in our study became dependent on others for help with basic daily activities (such as washing, dressing, feeding), developed dementia, and noted death or survival. We analysed how common weight loss was, and whether weight loss was associated with these outcomes.

Weight loss

Weight loss occurred more frequently in people with Parkinson’s than those without Parkinson’s, and even more quickly in those with other forms of parkinsonism.

While previous studies has shown that weight loss was common in Parkinson’s, we were surprised to find that weight loss often began early in the course of Parkinson’s.

Furthermore, people who lost weight early in the course of their disease (and did not regain the weight) did worse compared with those who did not lose weight early: they had approximately double the risk of all 3 outcomes we studied, dependency, dementia, and death.

Important findings

These findings are important. While we do not yet know whether weight loss causes these outcomes or is merely a consequence of more severe Parkinson’s, this raises the possibility that preventing or reversing weight loss may improve function in daily activities, delay dementia and improve survival.

Clearly more research is needed to find out why people who lose weight have poorer prognosis, and to investigate whether intervening with a high calorie diet in those who lose weight, for instance, could lead to important benefits in Parkinson’s and other forms of parkinsonism. We are planning a programme of research to try to find more definite answers to these questions.

Advice for people with Parkinson’s

In the meantime, what do I think people with Parkinson’s should do about this?

My advice would be that they keep an eye on their weight – checking it occasionally. If they start to steadily lose weight, it would be sensible to increase calorie intake to maintain a steady weight.

Everybody, whether or not they have Parkinson’s, should ensure that they have a healthy balanced diet.

Angus D Macleod is clinical lecturer in neurology at the University of Aberdeen