Mini Nutritional Assessment in patients with Parkinson's disease: correlation between worsening of the malnutrition and increasing number of disease-years.

OBJECTIVE: To monitor the nutritional status of patients with Parkinson's disease using the Mini Nutritional Assessment (MNA) questionnaire. PATIENTS AND METHODS: This was a 3-year longitudinal study conducted in a national referral centre for Parkinson's disease and other movement disorders. The cohort included 61 Parkinson's disease patients, 37 men and 24 women, mean age of 70.5 +/- 5.5 years, mean duration of disease 9 +/- 6.3 years; 35 patients were followed-up after 3 years. RESULTS: MNA score diminished from 24.9 +/- 1.6 to 24 +/- 2.5 (P = 0.02); the proportion of patients at risk of malnutrition increased from 22.9% to 34.3%. A linear correlation was observed between MNA score and the duration of disease (P = 0.0096). The dietary assessment subscore significantly diminished (8.6 versus 8.1; P = 0.0009) as did body mass index (25.9 +/- 3.5 kg/m(2) versus 27.1 +/- 3.1 kg/m(2); P = 0.001). CONCLUSIONS: The evaluation of nutritional status should be part of the routine work-up of a Parkinson's disease patient. Dietary education should be included amongst the therapeutic measures designed to improve the general conditions in Parkinson's disease.

Diet with LPP for renal patients increases daily energy expenditure and improves motor function in parkinsonian patients with motor fluctuations.

OBJECTIVE: To establish whether a diet based on the usage of low-protein products for renal patients (LPP) is associated with higher energy expenditure (EE) than a free low-protein diet (NO-LPP) by calculating 24 h EE by indirect calorimetry using an electronic armband monitor. DESIGN: Randomized, cross-over, single-blind, pilot clinical trial performed comparing two different low-protein dietary regimens. SUBJECTS: Forty-two days with LPP and 42 days with NO-LPP regimen in six patients with Parkinson's disease with levodopa. METHODS: Monitoring patient response to two different nutritional schemes through indirect calorimetry (armband), BMI, Patient Global Improvement Scale. RESULTS: Mean total EE was 1731 +/- 265 kcal/day with NO-LPP vs. 1903 +/- 265 kcal/day with LPP (p = 0.02). CONCLUSIONS: The usage of LPP increases EE and improves motor function in PD patients to a greater extent than NO-LPP dietary regimen. Calorie intake should be increased to prevent malnutrition in the long-term.