Nutritional Status, Cognition and Cardiometabolic Risk in Individuals with Neurological Disorders

Abstract

Background: Limited research has been done to monitor the progression of health outcomes in individuals with Parkinson's disease (PD) and acquired brain injury (ABI). Objective/Hypothesis: The purpose of this longitudinal study was to assess the natural progression of the disease process and its effects on nutritional status, cognition, and cardiometabolic risk over a two year time period in those living with PD and ABI ≥ 12 months post-diagnosis. Methods: Thirteen community-dwelling adults (9 with PD and 4 with ABI) were evaluated for nutritional status using the dietary screening tool (DST), cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and cardiometabolic risk factors using anthropometric, biochemical, and clinical assessments. Three evaluations separated by 6-12 month increments for each participant took place. Changes in nutritional status, cognition, and cardiometabolic risk were assessed using RMANCOVA (p<0.05). Results: Of the 9 participants with PD, 6 (66.7%) did not change nutritional risk categories over time; 2 worsened and 1 improved. Of the 4 participants with ABI, 2 (50%) did not change nutritional risk categories over time; 1 improved and 1 worsened. Time appeared to have a negative effect on cognition for participants with PD and a positive effect on cognition for participants with ABI. Six PD and 2 ABI participants had no change or fewer cardiometabolic risk factors over time, while 1 PD and 1 ABI had more cardiometabolic risk factors over time. Findings however were not statistically significant. Conclusion: Our data reinforces the notion of outcome heterogeneity in individuals with PD and ABI. Since nutritional status, cognition, and cardiometabolic risk factors are unique to each patient, it is of clinical importance to provide evaluation and treatment on an individual basis. More consistent, long-term evaluations are needed to detect disease progression trends and determine what risk factors occur when to guide intervention development.