Unintentional Weight Loss and Its Management in Patients with Parkinson's Disease

Abstract

Abstract Unintentional weight loss (UWL) is common in patients with Parkinson's disease (PD). Possible causes include increased energy expenditure due to tremor, dyskinesias, and rigidity; reduced energy intake due to PD‐related conditions, including olfactory dysfunction, cognitive impairment, depression, dysphagia, and deterioration in manual dexterity; and/or medication‐related side effects, including dry mouth, nausea/vomiting, appetite loss, anorexia nervosa, insomnia, fatigue, nervousness, and anxiety. In many cases, UWL is probably multifactorial. UWL increases the risk of malnutrition, morbidity and mortality, and the need for hospitalization, home health care, or long‐term care. Weight loss may be accompanied by loss of bone density and skeletal muscle. People with PD often have gait and balance impairment and increased incidence of falls, fractures, and hospitalization, and this loss of bone and muscle mass further increases these risks. Early nutrition intervention could potentially avert pain and trauma to the patient, as well as reduce the burden of health care costs. Management of weight loss should include a multidisciplinary team, including a primary care physician, a neurologist, a registered dietitian, and, when dysphagia or dysarthria is present, a speech‐language pathologist. Specialized interviewing skills and assessment techniques improve patient compliance and provide for successful therapy. Determining etiology of weight loss and individualizing patient education are necessary to guide therapy and improve the chances of success in attaining weight‐management goals. A case history is presented, demonstrating gradual long‐term weight loss, subsequent weight regain and increased ability to exercise, and a decrease in number of daily falls.