Earlier weight reduction related to quicker cognitive decline in Parkinson’s illness

Early weight loss after a diagnosis of Parkinson’s disease (PD) may be a precursor to more rapid deterioration in cognitive function, new research finds.

Results showed that in the first year after receiving a PD diagnosis, patients who lost more than 3% of their body weight experienced a faster decline in global and executive cognitive function than their peers who maintained or gained weight.

Study researcher Jin-Sun Jun, MD, Kangnam Sacred Heart Hospital in Seoul, Korea, noted in a press release that early weight loss is a common non-motor symptom in Parkinson’s and “could serve as a sign that people are at risk of developing cognitive decay exists. “

The results were published online in Neurology on October 19.

weighing the impact

Both weight loss and weight gain have previously been associated with later dementia in older populations. However, evidence of an association between early weight change and cognitive decline in Parkinson’s is lacking, the researchers note.

To investigate this further, they studied 358 adults (66% male; mean age 61 years) who had been diagnosed with Parkinson’s disease a median of 2 years previously. In the first year after diagnosis, 98 participants lost more than 3% of their body weight, 201 maintained their weight (within ±3%), and 59 gained more than 3% of their body weight.

Compared to those who maintained their weight, participants who lost weight experienced a significantly faster decline in Montreal Cognitive Assessment (MoCA) scores (β = -0.19; 95% CI, -0.28 to -0 .10; P=0.001). MoCA measures overall cognitive performance.

In terms of specific cognitive domains, those who lost weight showed a steeper decline in sematic fluid test scores (β = -0.37; 95% CI, -0.66 to -0.08; P=0.01). MoCA phonemic fluency scores (β = -0.18; 95% CI, -0.31 to -0.05; P = 0.005) and, to a lesser extent, letter-number sequencing scores (β = -0.07, 95 %CI, -0.14 to 0.01, P=0.07).

Conversely, patients with Parkinson’s who gained weight had a slower decline in Symbol-Digit Modalities Test scores (β=0.34; 95% CI, 0.05-0.63). However, no association with longitudinal changes in MoCA scores was found.

There was no significant effect of weight change on the progression of other non-motor symptoms.

The researchers note that the results highlight the potential importance of weight management in the early stages of PD.

More studies are needed to determine whether weight-loss prevention measures might slow cognitive decline in adults with Parkinson’s, they add.

Cognitive deconditioning?

Commenting on the findings for Medscape Medical News, Shaheen Lakhan, MD, a neurologist and researcher from Boston, Massachusetts, noted that there are many reasons why weight loss in patients with neurodegenerative diseases like Parkinson’s is correlated with brain health.

“First, unintentional weight loss may indicate poor nutritional status and nutritional deficiencies that directly limit cognitive function,” said Lakhan, who was not involved with the research.

He added that it could also represent physical deconditioning, “where body fat is lost and then muscles atrophy, but also cognitive deconditioning, where the brain becomes less stimulated as muscle and neurocircuitry fails.”

“This line of research reminds us neurologists not only to monitor tremors and other movements associated with Parkinson’s, but also body measurements like weight and BMI [body mass index] to more fully personalize medicine,” Lakhan said.

The study was supported by the Hallym University Research Fund 2019. Kim and Lakhan have not reported any relevant financial relationships.

Neurology. Published online October 19, 2022. Abstract

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