HONOLULU – Nutritional assessments of 210 consecutive patients with Parkinson’s disease found malnutrition, weight loss, dysphagia, constipation, and other reasons for dietary treatment in high proportions of patients.
The assessments of patients who were admitted to the Parkinson Institute at Istituti Clinici di Perfezionamento, Milan, showed that 75% were taking levodopa (average dose 509 mg/day). The investigators prescribed a low-protein lunch to these patients and advised them to take their medications 30 minutes before meals to improve levodopa absorption, Dr. Michela Barichella and her associates reported in a poster presentation at the annual meeting of the American Academy of Neurology.
Postprandial motor blocks caused by protein’s interference with levodopa absorption occurred in 32% of the patients. They were prescribed low-protein products, according to Dr. Barichella, a neurologist at the institute.
The patients’ mean body mass index was 27 kg/m2. By using the Malnutrition Universal Screening Tool, Dr. Barichella and her colleagues found moderate to severe malnutrition in 10%, and 4% of patients reported losing more than 10% of their weight in the previous 6 months. The investigators prescribed high-calorie, low-protein oral supplements to patients with malnourishment or rapid weight loss.
Constipation in 59% of the patients was treated with soluble fiber supplements.
For the 28% of patients with fluids-related dysphagia, the investigators prescribed fluid thickeners. Another 11% who had general dysphagia were told to follow a semisolid dietary regimen.
Complete nutritional status assessments are recommended as part of a multidisciplinary approach to Parkinson’s disease, the investigators noted. Validated diagnostic scales are available for early diagnosis and monitoring of dysphagia and constipation.
The findings suggest that dysphagia for solids and liquids is a common, dangerous, and often undetected condition in patients with Parkinson’s disease that can be managed by dietary measures, the investigators concluded.
Dr. Barichella and her associates reported having no relevant conflicts of interest.