Relationship between sarcopenia with malnutrition in elderly parkinson patients

Parkinson's disease (PD) is the second most common neurodegenerative and progressive disease after Alzheimer's disease. It typically develops between the ages of 55 and 65 and incidence increases around 60 ages on average. These patients may be at higher risk of malnutrition and sarcopenia because of the symptoms associated with non-motor symptoms such as tremor, movement slowing and contraction in muscles, inability to move, contraction in limbs, inconsistent walking and humpback and motor symptoms such as sleep disorders, constipation, loss of sense of smell, depression, sexual dysfunction and anxiety and also side effect of drugs. However, there is not sufficient and clear data in the literature. Therefore, our aim is to determine the prevalence of sarcopenia and malnutrition in elderly Parkinson's patients, to investigate the relationship between sarcopenia and malnutrition and to investigate whether this patient group is associated with sarcopenia and malnutrition in terms of both the severity of the disease and the risk of swallowing disorder. For this purpose, 89 patients (mean age 68.9 ± 6.4 years, %42,7 women, %57,3 men) with a diagnosis of PH over 60 years of age who applied to the Neurology Clinic of Ege University Hospital between June 2018 and March 2019 were included in the study. Mini-Nutritional Assessment (MNA) test in terms of malnutrition, EAT-10 test in terms of risk of swallowing disorder, PASE questionnaire for physical activity evaluation, Hoehn-yahr scale in terms of disease severity, anthropometric measurements (height, body weight, calf circumference(CC), upper middle arm circumference(MUAC)), walking speed, hand force and body composition measurements were performed. EWSGOP 2 criteria were used for the definition of sarcopenia. The data were evaluated with SPSS 22.0 package program. Patients were found to be malnutrition at 5,6%, under the risk of malnutrition at 43,8% and as normal at 50,6% with MNA. 87,7% were not sarcopenic, and 12,3% were advanced sarcopenia. A statistically significant relationship was found between sarcopenia and malnutrition (p = 0,001). While the disease severity was associated with sarcopenia, no association with malnutrition was found. Although 48,3% patients have the risk of swallowing disorder but it was not associated with either sarcopenia or malnutrition. The cut-off value of the phase angle was determined to be <4.5 with 53,3% sensitivity and 93,2% specificity in terms of adequacy of showing sarcopenia (p = 0,001). It is important to be aware of sarcopenia and malnutrition in the early stages of the PD and to make the necessary screening and evaluation (risk factors such as weight loss, low handgrip strenght, CC and BMI) to prevent.