Parkinson Disease Weight Loss Predictors: Age, Gender, Cognition

Recent research published in the Journal of Neurology found that cognition scores, female gender, age, postural instability, and type of dopaminergic therapy to be among the independent predictors of weight loss in patients with early Parkinson disease.

Weight loss is a common symptom of PD and can impair patients’ quality of life, but thus far predictors of weight loss have not been studied in large clinical cohorts. Researchers for this study began their present investigation after observing an association between change in body mass index and change in Unified Parkinson’s Disease Rating Scale (UPDRS) motor and total scores in patients.

In this study, authors Anne-Marie Wills, MD, MPH, Massachusetts general Hospital (Boston, MA), and coauthors analyzed patient data from the prospective, randomized, multicenter, placebo-controlled National Institute of Neurological Disorders and Stroke Exploratory Trial in PD Long-term Study-1. Dr Wills’ team sought to measure and compare weight change in 1619 people with early PD (within 5 years of diagnosis and within 2 years of starting dopaminergic medications) at 12, 24, 36, 48, 60, and 72 months with baseline levels. Linear mixed models were used to estimate the effect of baseline clinical covariates on weight change over time (2017;264[8]:1746-1753).
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On average, participants lost only 0.6 kg per year. Higher age, baseline weight, female gender, higher baseline UPDRS scores, greater postural instability, difficulty eating and drinking, lower cognitive scores and baseline levodopa use (compared to dopamine agonists) were all associated with weight loss. Older patients with PD also lost weight more quickly than younger patients. Additionally, with each unit increase of average tremor score, there was a significant weight increase of 0.51 kg/year (P < .001).

Researchers were surprised that baseline difficulty swallowing, dyskinesia, depression, intestinal hypomotility (constipation) and self-reported nausea/vomiting/anorexia were not significantly associated with weight loss in this patient cohort. Dr Wills and coauthors believe a follow-up study measuring “dietary intake, appetite, olfaction, and other autonomic features” could improve understanding of PD-associated weight loss.—Amanda Del Signore