title: Weight loss, dysphagia and supplement intake in patients with amyotrophic lateral sclerosis (ALS): impact on quality of life and therapeutic options.
abstract: BACKGROUND
  Weight loss is a frequent feature in the motor neuron disease Amyotrophic lateral sclerosis (ALS). In this study we investigated possible causes of weight loss in ALS, its impact on mood/quality of life (QOL) and the benefit of high calorie nutritional/other dietary supplements and percutaneous endoscopic gastrostomy (PEG).
  
  
  METHODS
  121 ALS patients were interviewed and answered standardized questionnaires (Beck depression inventory - II, SF36 Health Survey questionnaire, revised ALS functional rating scale). Two years after the initial survey we performed a follow-up interview.
  
  
  RESULTS
  In our ALS-cohort, 56.3% of the patients suffered from weight loss. Weight loss had a negative impact on QOL and was associated with a shorter survival. Patients who took high calorie nutritional supplements respectively had a PEG stated a great benefit regarding weight stabilization and/or QOL.38.2% of our patients had significant weight loss without suffering from dysphagia. To clarify the reasons for weight loss in these patients, we compared them with patients without weight loss. The two groups did not differ regarding severity of disease, depression, frontotemporal dementia or fasciculations, but patients with weight loss declared more often increased respiratory work.
  
  
  CONCLUSIONS
  Weight loss is a serious issue in ALS and cannot always be attributed to dysphagia. Symptomatic treatment of weight loss (high calorie nutritional supplements and/ or PEG) should be offered more frequently.
authors.affiliation: Department of Neurology, Hannover Medical School, Carl-Neuberg-Str, 1, Hannover 30625, Germany. Koerner.Sonja@mh-hannover.de
authors.forename: Sonja
authors.initials: S
authors.lastname: Körner
authors.forename: Melanie
authors.initials: M
authors.lastname: Hendricks
authors.forename: Katja
authors.initials: K
authors.lastname: Kollewe
authors.forename: Antonia
authors.initials: A
authors.lastname: Zapf
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dengler
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Silani
authors.forename: Susanne
authors.initials: S
authors.lastname: Petri
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000523:psychology / Q000628:therapy; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000379:methods*; D010045:Outpatients; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D015431:Weight Loss / Q000502:physiology*