Department of Neurology, Jena University Hospital, Jena, Germany.
Center for Healthy Ageing, Jena University Hospital, Jena, Germany.
PLoS One. 2020 May 4;15(5):e0232764. doi: 10.1371/journal.pone.0232764. eCollection 2020.
This study aimed to explore the association between malnutrition, clinical parameters, and health-related quality of life in elderly hospitalized patients with Parkinson's disease (PD).
Cross-sectional study of 92 hospitalized elderly patients with PD (mean age 73.6 ± 6.7 years) without dementia. The Mini Nutritional Assessment (MNA) was used to evaluate nutritional status. Motor impairment and non-motor symptoms burden (Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale [MDS-UPDRS], Non-Motor Symptoms Questionnaire, and Hoehn & Yahr staging), depression (Becks Depression Inventory-II), and health-related quality of life (PD quality of life Questionnaire-39) were assessed.
Every second patient was malnourished or at risk of malnutrition. In the multivariable analysis, male gender, longer disease duration, higher Hoehn & Yahr and depression were associated with total MNA score. Besides non-motor symptoms and motor impairment, malnutrition was an independent predictor of poor health-related quality of life. In the multivariate analysis, malnutrition had a statistically significant effect on emotional well-being, mobility, social support, stigmatization, and cognition. The strongest association was found between malnutrition and emotional well-being.
Elderly male persons with longer PD duration and higher disease stages are more likely to be malnourished or at risk for malnutrition. Malnutrition was mainly associated with poor emotional well-being, suggesting that treatment of depression and anxiety beside diet and physical activity can help improving nutrition status in these subjects. The MNA should not be used independent of other measures of cognition and depression in people with advanced PD.
本研究旨在探讨老年住院帕金森病(PD)患者营养不良与临床参数及健康相关生活质量之间的关系。
这是一项横断面研究,共纳入 92 例无痴呆的住院老年 PD 患者(平均年龄 73.6 ± 6.7 岁)。采用微型营养评估(MNA)评估营养状况。评估运动障碍和非运动症状负担(运动障碍协会赞助的统一帕金森病评定量表修订版[MDS-UPDRS]、非运动症状问卷和 Hoehn & Yahr 分期)、抑郁(贝克抑郁量表-II)和健康相关生活质量(帕金森病生活质量问卷-39)。
每两个患者中就有一个存在营养不良或有营养不良风险。在多变量分析中,男性、更长的病程、更高的 Hoehn & Yahr 分期和抑郁与总 MNA 评分相关。除非运动症状和运动障碍外,营养不良是健康相关生活质量差的独立预测因素。在多变量分析中,营养不良对情绪健康、活动能力、社会支持、污名化和认知有统计学意义。营养不良与情绪健康之间的关联最强。
老年男性、病程较长和疾病分期较高者更易出现营养不良或有营养不良风险。营养不良主要与情绪健康不佳有关,这表明在这些患者中,除饮食和体育活动外,治疗抑郁和焦虑也有助于改善营养状况。在晚期 PD 患者中,MNA 不应独立于认知和抑郁的其他测量指标使用。