title: Nutritional risk and gastrointestinal dysautonomia symptoms in Parkinson's disease outpatients hospitalised on a scheduled basis.
abstract: Dysautonomia symptoms of nutritional interest may often occur in Parkinson's disease (PD), but the role played in affecting the risk of malnutrition still needs to be clarified. A total of 208 consecutive PD outpatients hospitalised on a scheduled basis were assessed for nutritional risk by the Malnutrition Universal Screening Tool. Presence of dysautonomia symptoms (dysphagia, sialorrhoea and constipation) was investigated using clinical rating scales. In our population, prevalence of nutritional risk was 17·2 (95 % CI 12·1, 24·0) % and relied mainly on unintentional weight loss. Sialorrhoea, dysphagia, dysphagia to liquids and constipation were observed in 10·6, 11·0, 14·4 and 59·6 % of the patients, respectively. Nutritional risk was independently associated with the number of dysautonomia symptoms (OR 1·39 (95 % CI 1·00, 1·96); P= 0·048) but not with single symptoms. An independent association was also found with the severity of motor symptoms (Hoehn-Yahr stage, OR 1·48 (95 % CI 1·00, 2·55); P= 0·049) and levodopa dose (OR 1·16 (95 % CI 1·04, 1·31) mg/kg per d; P= 0·009). Nutritional risk in PD outpatients appears to depend mainly on dysautonomic syndrome, disease severity and levodopa dosage. Implications for outcome deserve further investigation. The assessment of nutritional status and of gastrointestinal dysautonomia symptoms should be part of the routine work-up of a PD patient.
authors.affiliation: Parkinson Institute, Istituti Clinici di Perfezionamento, via Bignami 1, 20126 Milan, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Barichella
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cereda
authors.forename: Carmen
authors.initials: C
authors.lastname: Madio
authors.forename: Laura
authors.initials: L
authors.lastname: Iorio
authors.forename: Chiara
authors.initials: C
authors.lastname: Pusani
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cancello
authors.forename: Riccardo
authors.initials: R
authors.lastname: Caccialanza
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
authors.forename: Erica
authors.initials: E
authors.lastname: Cassani
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D003248:Constipation / Q000453:epidemiology / Q000209:etiology; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009752:Nutritional Status; D016017:Odds Ratio; D010045:Outpatients; D010300:Parkinson Disease / Q000150:complications*; D015995:Prevalence; D054969:Primary Dysautonomias / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012720:Severity of Illness Index; D012798:Sialorrhea / Q000453:epidemiology / Q000209:etiology; D015431:Weight Loss
chemical_list: D007980:Levodopa