Lorefält Birgitta, Granérus Ann-Katherine, Unosson Mitra
Department of Medicine and Care, Faculty of Health Science, Linköping, Sweden.
J Clin Nurs. 2006 Nov;15(11):1404-12. doi: 10.1111/j.1365-2702.2005.01454.x.
The aim of this paper was to investigate to what extent parkinsonian symptoms, including mild dysphagia and other eating problems, could influence the choice of consistency and the amount of food intake and if this could be related to weight loss as an expression of the underlying neurodegenerative process.
Previous studies show that patients with Parkinson's disease tend to lose body weight even early during the disease.
The design was a longitudinal prospective study.
Twenty-six free-living Parkinson's disease patients and 26 age- and sex-matched controls were investigated twice, with one-year apart, with focus on Parkinson's disease symptoms, as well as swallowing function. Intake of food items and food consistency were assessed by food records, completed over three consecutive days at each investigation.
In patients with weight loss, motor symptoms, problems with activities of daily living and problems with eating, related to motor symptoms, increased and they had more dysphagia compared with their controls. They consumed lower amounts of fluid and solid food on both investigated occasions, compared with their controls. Multiple regression analysis showed that weight loss was associated with female gender, eating difficulties related to activities of daily living and preference towards soft food, but negatively correlated with age.
Parkinson's disease patients with weight loss seemed to avoid solid food, partly because of eating difficulties. Eating problems, as well as weight loss, could be because of the underlying disease, even when it is not at an advanced stage.
Caring for patients with Parkinson's disease should not only include medical treatment, but also support for adequate food intake to prevent weight loss.
本文旨在研究帕金森氏症症状,包括轻度吞咽困难和其他进食问题,在何种程度上会影响食物质地的选择和食物摄入量,以及这是否与作为潜在神经退行性过程表现的体重减轻有关。
先前的研究表明,帕金森病患者即使在疾病早期也往往会体重减轻。
采用纵向前瞻性研究设计。
对26名居家生活的帕金森病患者和26名年龄及性别匹配的对照者进行了两次调查,间隔一年,重点关注帕金森病症状以及吞咽功能。通过食物记录评估食物种类和食物质地的摄入情况,每次调查时连续记录三天。
体重减轻的患者,其运动症状、日常生活活动问题以及与运动症状相关的进食问题有所增加,与对照组相比,他们有更多的吞咽困难。在两次调查中,与对照组相比,他们摄入的液体和固体食物量都更低。多元回归分析表明,体重减轻与女性性别、与日常生活活动相关的进食困难以及对软食的偏好有关,但与年龄呈负相关。
体重减轻的帕金森病患者似乎会避免食用固体食物,部分原因是进食困难。进食问题以及体重减轻可能是由潜在疾病引起的,即使疾病尚未处于晚期。
对帕金森病患者的护理不仅应包括药物治疗,还应支持其充足的食物摄入以防止体重减轻。