School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
PLoS One. 2013;8(3):e57986. doi: 10.1371/journal.pone.0057986. Epub 2013 Mar 27.
In Parkinson's disease (PD), commonly reported risk factors for malnutrition in other populations commonly occur. Few studies have explored which of these factors are of particular importance in malnutrition in PD. The aim was to identify the determinants of nutritional status in people with Parkinson's disease (PWP).
Community-dwelling PWP (>18 years) were recruited (n = 125; 73M/52F; Mdn 70 years). Self-report assessments included Beck's Depression Inventory (BDI), Spielberger Trait Anxiety Inventory (STAI), Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT), Modified Constipation Assessment Scale (MCAS) and Freezing of Gait Questionnaire (FOG-Q). Information about age, PD duration, medications, co-morbid conditions and living situation was obtained. Addenbrooke's Cognitive Examination (ACE-R), Unified Parkinson's Disease Rating Scale (UPDRS) II and UPDRS III were performed. Nutritional status was assessed using the Subjective Global Assessment (SGA) as part of the scored Patient-Generated Subjective Global Assessment (PG-SGA).
Nineteen (15%) were malnourished (SGA-B). Median PG-SGA score was 3. More of the malnourished were elderly (84% vs. 71%) and had more severe disease (H&Y: 21% vs. 5%). UPDRS II and UPDRS III scores and levodopa equivalent daily dose (LEDD)/body weight (mg/kg) were significantly higher in the malnourished (Mdn 18 vs. 15; 20 vs. 15; 10.1 vs. 7.6 respectively). Regression analyses revealed older age at diagnosis, higher LEDD/body weight (mg/kg), greater UPDRS III score, lower STAI score and higher BDI score as significant predictors of malnutrition (SGA-B). Living alone and higher BDI and UPDRS III scores were significant predictors of a higher log-adjusted PG-SGA score.
In this sample of PWP, the rate of malnutrition was higher than that previously reported in the general community. Nutrition screening should occur regularly in those with more severe disease and depression. Community support should be provided to PWP living alone. Dopaminergic medication should be reviewed with body weight changes.
在帕金森病（PD）中，其他人群中常见的营养不良的常见风险因素也普遍存在。很少有研究探讨这些因素中哪些对 PD 患者的营养不良特别重要。本研究旨在确定帕金森病患者（PWP）营养状况的决定因素。
招募了社区居住的 PWP（>18 岁）（n=125；73M/52F；中位数 70 岁）。自我报告评估包括贝克抑郁量表（BDI）、斯皮尔伯格特质焦虑量表（STAI）、帕金森病自主功能量表（SCOPA-AUT）、改良便秘评估量表（MCAS）和冻结步态问卷（FOG-Q）。获得了年龄、PD 病程、药物、合并症和生活状况的信息。进行了 Addenbrooke 认知测验（ACE-R）、统一帕金森病评定量表（UPDRS）II 和 UPDRS III。营养状况通过主观整体评估（SGA）作为评分患者生成主观整体评估（PG-SGA）的一部分进行评估。
19 人（15%）存在营养不良（SGA-B）。PG-SGA 的中位数评分为 3 分。营养不良者更年长（84% vs. 71%），疾病更严重（H&Y：21% vs. 5%）。营养不良者的 UPDRS II 和 UPDRS III 评分以及左旋多巴等效日剂量（LEDD）/体重（mg/kg）明显更高（Mdn 18 分 vs. 15 分；20 分 vs. 15 分；10.1 分 vs. 7.6 分）。回归分析显示，诊断时年龄较大、LEDD/体重（mg/kg）较高、UPDRS III 评分较高、STAI 评分较低和 BDI 评分较高是营养不良（SGA-B）的显著预测因素。独居、BDI 和 UPDRS III 评分较高是 log 调整后 PG-SGA 评分较高的显著预测因素。
在本研究的 PWP 样本中，营养不良的发生率高于先前在普通人群中报道的发生率。应定期对病情较重和抑郁的患者进行营养筛查。应向独居的 PWP 提供社区支持。应根据体重变化审查多巴胺能药物。
