Cognitive score, female gender, age, postural instability, and type of dopaminergic therapy are among independent predictors for weight loss in patients with early Parkinson disease (PD), according to an analysis of patient data from a randomized, double-blind trial reported in the Journal of Neurology.
Investigators examined weight loss predictors among 1619 people with early PD from the prospective, randomized, multicenter, placebo-controlled National Institute of Neurological Disorders and Stroke Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1). Specifically, the researchers sought to measure and compare weight change at 12, 24, 36, 48, 60, and 72 months with baseline levels.
Participants in the analysis lost an average of 0.6 kg/year. Predictors for weight loss in this cohort included female gender, difficulty eating and drinking, lower cognitive scores, more postural instability, and age. Dopaminergic replacement therapy (1-6 years) during the early stages of PD was associated with little weight loss; however, an average weight loss of 0.28 kg more per year was observed in patients receiving levodopa compared with those on dopamine agonists only (P =.014).
There was an average loss of 0.025 kg/year for every kilogram more that participants weighed at baseline. During the study period, older patients with PD also lost weight more quickly than younger patients. Additionally, with each unit increase of average tremor score, there was a significant weight increase of 0.51 kg/year (P <.001).
Enrollment of patients with only early PD in this trial prevents generalization of the study’s findings across the entire PD population. The investigators also noted that a longer follow-up period may be necessary to assess more gradual weight loss in PD.
The researchers believe a follow-up study “which measures dietary intake, appetite, olfaction, and other autonomic features” may be necessary to improve understanding of PD-associated weight loss.
Wills AM, Li R, Pérez A, Ren X, Boyd J, NINDS NET-PD Investigators. Predictors of weight loss in early treated Parkinson’s disease from the NET-PD LS-1 cohort. J Neurol. 2017;264(8):1746-1753.