Cumming K, et al. - Researchers performed this study to compare weight change over time in patients with Parkinson's disease (PD), those with atypical parkinsonism, and matched controls. Furthermore, they identified baseline factors that influence weight loss in parkinsonism and investigated whether it predicted poor outcome. They found weight loss in early parkinsonism. Compared to PD, weight loss was greater in atypical parkinsonism. In parkinsonism, early weight loss had prognostic significance. Targeted dietary interventions to prevent it could improve long-term outcomes.

Methods

• Data was examined from the Parkinsonism Incidence in North-East Scotland (PINE) study, an incident, population-based prospective cohort of parkinsonian patients and age- and sex-matched controls with annual follow-up.
• In the mixed-model analysis, weight change in patients with PD, those with atypical parkinsonism, and controls was described.
• The researcher studied baseline determinants of sustained clinically significant weight loss (>5% loss from baseline) and associations between early sustained weight loss and death, dementia, and dependency in parkinsonism, with Cox regression.

Results

• For a median of 5 years, 515 participants (240 controls, 187 with PD, 88 with atypical parkinsonism) were followed up.
• Atypical parkinsonian patients had lower body weights than patients with PD, who were lighter than controls, at diagnosis.
• Compared to controls, patients with PD lost weight more rapidly, and weight loss was most rapid in atypical parkinsonism.
• Only age was independently correlated with sustained clinically significant weight loss (hazard ratio [HR] for 10-year age increase 1.83, 95% confidence interval [CI] 1.44-2.32) after multivariable adjustment for potential confounders.
• Within 1 year of diagnosis, lossing weight was independently associated with increased risk of dependency (HR 2.11, 95% CI 1.00-4.42), dementia (HR 3.23, 95% CI 1.40-7.44), and death (HR 2.23, 95% CI 1.46-3.41).