Perda de peso e desnutrição na doença de parkinson: revisão sistemática

Abstract

Parkinson's disease (PD) is considered the second most common neurodegenerative disease in individuals aged 60 and above, surpassed only by Alzheimer's disease. James Parkinson had already reported on weight loss in his first publication on individuals with parkinsonism, but only recently has greater attention been paid to weight changes in PD, possibly due to increased concern for healthy eating. Weight loss, coupled with motor and non-motor symptoms present in PD, places individuals at risk of malnutrition. Objective: To systematically establish whether malnutrition or unintentional weight loss correlates with disease progression measured by the Hoehn and Yahr (HY) score and the Unified Parkinson’s Disease Rating Scale (UPDRS). Methods: Studies addressing weight loss or malnutrition associated with PD were searched in five databases, with filters up to July 2023. Results: Eight studies were included, evaluating the nutritional status of individuals based on Body Mass Index (BMI) and/or Mini Nutritional Assessment (MNA). All studies evaluated BMI, with the lowest mean being 22.6 ± 3.4 kg/m², while MNA was assessed by only three studies. Most found studies related poorer nutritional status to longer duration of PD. Correlations were also observed between worse outcomes on UPDRS, HY scales, cognitive scales, and poorer nutritional status (BMI or MNA). Overall, selected works indicated that individuals with worse nutritional states also used higher doses of levodopa. Conclusion: Individuals with PD presenting malnutrition, risk of malnutrition, or unintentional weight loss show associations with longer disease duration, greater severity, higher scores on HY and UPDRS scales, cognitive scales, as well as higher levodopa/kg doses, leading to motor complications related to this medication.