Wednesday, November 30, 2022

Parkinson’s Dementia And Weight Loss

Coping With A Parkinsons Diagnosis

Weight Loss in Parkinsonism

A diagnosis of Parkinsons can be a frightening experience for both you and your loved ones. While there is currently no cure, there are treatments available for Parkinsons symptoms and lifestyle changes you can make to slow the progression of the disease and delay the onset of more debilitating symptoms, including Parkinsons disease dementia. Early diagnosis can prolong independence and help you to live life fully for much longer.

If youve been diagnosed with Parkinsons you may feel anger, deep sadness, or fear about what the future will bring. These feelings are all normal. Its also normal to grieve as you deal with this enormous adjustment.

Give yourself some time to adjust. As with any major change in life, dont expect that you will smoothly snap into this new transition. You may feel alright for a while, and then suddenly feel stressed and overwhelmed again. Take time to adjust to this new transition.

Learn all you can about Parkinsons disease and Parkinsons disease dementia. Educating yourself and making important decisions early can help you feel more in control during this difficult time.

Reach out for support. Living with Parkinsons presents many challenges, but there is help available for this journey. The more you reach out to others and get support, the more youll be able to cope with symptoms while continuing to enrich and find meaning in your life.

Proper Nutrition And Parkinsons Disease

Parkinsons disease is a central nervous system disorder with far-reaching effects on the daily lives of its sufferers. People with Parkinsons often struggle with movement problems, including tremors, difficulty walking, limb stiffness, stooped posture, and a slow, shuffling gait. In addition to these common physical symptoms, Parkinsons patients can experience sleep disturbances, depression, and dementia.

For people with Parkinsons, good nutrition is key to maintaining quality of life and preserving independence. However, the physical symptoms of Parkinsons can make it more difficult to shop and prepare meals. Additionally, psychiatric symptoms, like depression, can lead to a loss of appetite. Some medications used to treat Parkinsons can have side effects, such as nausea, that also lead to a loss of appetite. Among people with Parkinsons, skipping meals or simply forgetting to eat, is common. However, a balanced diet is essential, particularly when combating Parkinsons symptoms: weight loss and malnutrition can lead to a weakened immune system, loss of bone mass, and muscle deterioration.

Edison Home Health Care is happy to advise and assist you or any loved one who seek appropriate care of Parkinsons disease. Give us a call at 888-311-1142, or fill out a contact form and we will respond shortly.

Body Weight Loss In Dementia

Unintentional BW loss is a prominent clinical feature in some individuals with dementia . For example, data indicate that 3040% of patients with dementia may experience clinically significant weight loss . Body weight loss in dementia may be characteristic of reduced nutritional status, which is partially explained by a reduced food intake . It has been shown that 1445% of community-dwelling patients with mild-to-moderate AD, and up to 68% of patients with severe AD, are at risk of malnutrition . Body weight loss is also observed in transgenic mouse models of dementia that recapitulate underlying neurodegenerative pathologies , albeit inconsistently , as this loss may also be explained by model-specific developmental problems or strain-specific genetic effects .

Unintentional BW loss is detrimental for the frail elderly because it is associated with higher rates of mortality , institutionalization , adverse health outcomes, decline in functional status, and overall poorer quality of life . In elderly with dementia, unintentional BW loss is associated with syndrome severity , higher rates of institutionalization , a higher incidence of behavioral problems , and ultimately mortality . In contrast, a BMI equal to or higher than overweight has been associated with reduced mortality in dementia . Thus, it appears that low or healthy adult BMI can lead to poorer health outcomes in patients with dementia, while a higher BMI may be protective.

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Increased Resting Energy Expenditure

Using indirect calorimetric methods, Levi et al. and Markus et al. consistently observed increased REE, which was significantly associated with muscle rigidity, both in the untreated state and treated state . In consistency with the results, Marianna et al also found that REE was higher in the off state, and could be decreased by 8% after dopaminergic therapy . In contrast, Delikanaki-Skaribas et al. and Toth et al. reported that there was no difference in REE between neither PD patients and healthy controls nor weight loss and weight stable PD patients. Moreover, according to recent data, normalization of REE may contribute to the weight gain after DBS surgery . However, other authors reported that REE remains unchanged in PD patients treated with STN-DBS .

Why Weight Loss Is Concerning

Alzheimer

Researchers have found that weight loss, defined as the loss of an average of one pound per month, is linked with a significantly lower quality of life. Though weight loss was not found to lower survival, the small sample size of some of these studies makes a true judgment of the effect of weight loss on survival difficult to assess.

One concern is that people with Parkinson’s disease appear to be at a higher risk of osteoporosis, and osteoporosis is a significant cause of both illness and death in older adults. Weight loss has been found to increase the risk of osteoporosis in people with PDpeople who already have an elevated risk of developing osteoporosis. Weight loss also increases the risk of pressure ulcers , another condition which is already increased in people with PD due to a redistribution of body fat and restriction of movement. More than just weight loss, Cachexia is another concern and is considered a significant cause of premature death.

One study found that those with PD who lost weight had faster disease progression. However, researchers aren’t sure if weight loss causes Parkinson’s to worsen or if weight loss is the result of the more severe disease.

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What Should I Eat Before And After I Exercise

In the same way that theres no one diet for anyone, the timing of your meals before and after exercise will largely depend on you. While its important to limit your protein intake after taking your carb/levodopa, if you want a pre-workout snack, you can choose something light and carbohydrate-based, as this wont interfere with the absorption of your medicine. After you work out, it may be a good time for a protein-rich snack, so long as it is eaten at least 30 minutes before your next dose of medicine. With that framework, the exact type and timing of snacks before and after exercise is something that you can experiment with and talk to your doctor about.

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Life Expectancy By Stage Of The Disease

The average number of years a person lives with Alzheimers disease is about 10. Keep in mind, however, that theres a gap between when symptoms begin and when a diagnosis is actually sought. The first symptoms of Alzheimers diseaseforgetting names, misplacing items, difficulty concentrating at work or performing simple tasksarrive an average of almost three years before the diagnosis is made.

The scale most commonly used by health professionals for the stages of dementia is the Global Deterioration Scale , also called the Reisberg Scale. The table below shows a patients average life expectancy by the stage of dementia. These are averages based on studies of large numbers of Alzheimers patients.

Life Expectancy By Stage of Alzheimers / Dementia
Stage
Stage 7: Very Severe Cognitive Decline 1.5 to 2.5 years 2.5 years or less

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No Matter What I Do I Keep Gaining Weight Whats Happening And What Can I Do About It

Weight gain is another common side effect that can occur from a decreased ability to exercise or as a result of gastric emptying, in which you may feel like youre uncontrollably gaining weight despite not eating much. The discrepancy may have to do with your body going into starvation mode as it tries to recalibrate your energy input and output. Again, the best course of action is to speak with your doctor about a weight loss plan that aligns with your specific issues and goals. Also, you might consider an anti-inflammatory diet if youre suffering from weight gain associated with gastric emptying.

Be Generous With Spices

Thinking and Memory Problems with Parkinson Disease

Eating and drinking can still bring people with dementia pleasure, even in later stages. Encourage them to consume foods that they enjoy. If your loved one is near you while youre cooking, the aroma can whet their appetite. Taste buds also decrease with age and peoples ability to taste may change further due to dementia, so make the food flavorful.

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What Can You Do

Just being more perceptive of an elderly adults change in weight is already a good start. When caregivers of Alzheimers disease patients participated in a nutrition education program, they saw a decrease in patients with significant weight loss. Together with this, those under the program also had a better cognitive function.

The nutrition program walked the caregivers through the consequences of weight loss in dementia patients. It focused on how to enrich foods, increase protein intake, and replace food that the elderly individual refuses to eat. But it also tackled how to cope with behaviors like only eating small amounts of food or refusing to use utensils.

Youve probably heard about dementia before. This may or may not be the first time youre hearing about its relation to weight loss. But in a disease with a lot of uncertainties and no specific cure, our knowledge is power. While we wait for more rigorous and robust research to explain to us why weight loss tumbles into cognitive decline, we continue to keep ourselves educated on what we can do to mitigate these symptoms.

Potential Role For Medical Foods

The pursuit of novel dementia treatments has led to the development of novel nutritional interventions such as medical foods. Medical foods are not dietary supplements owing to legal definitions, and variation exists cross-nationally as to whether a medical prescription is necessary for their use, thus complying with the pharmacotherapy framework of this review . The term medical food is defined as a food which is formulated to be consumed or administered enterally under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation . In contrast, dietary supplements are products that contain a dietary ingredient intended to add to the nutritional value of the diet . Both medical foods and nutritional supplements have been developed to improve dementia outcomes, but for the sake of brevity and the focus of this review on pharmacotherapies, only medical foods are discussed here. .

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Why Knowing Life Expectancy Is Useful

Knowing what to expect, including life expectancy helps with planning. Someone predicted to survive for five or six years, as opposed to two years, will want to make more extensive plans, including getting an estate in order, activity planning, and budget. Knowing how quickly the disease is expected to progress symptomatically can impact care decisions. If the disease is predicted to come on very quickly, for example, then skipping traditional assisted living and looking into memory care or a nursing home might be the best option.

Knowing when full-time care becomes a requirement, either at-home or in a memory care residence, is especially useful given the high cost of care. It is estimated that 50% of nursing home residents have some level of dementia and over 60% of nursing home residents care is paid for by Medicaid. Medicaid eligibility is complicated, and families can spend up to 5 years waiting for a loved one with dementia to become Medicaid-eligible. Therefore, knowing how soon care is required can make a huge financial difference.

Contribute anonymously to our dementia life expectancy database. Start here.

I Was Telling Someone At My Parkinsons Support Group About The Pains I Have In My Stomach And He Mentioned Something Called Gastric Emptying What Is It And If Thats My Issue What Can I Do About It

Our Parkinson

Gastric emptying or gastroparesis relates to a delayed movement of food from the stomach to the intestines that can cause stomach pains, bloating, nausea and feelings of uncomfortable fullness after only a bite or two of food. Its not known whether this condition is associated with Parkinsons itself or levodopa treatment, but whether it is or isnt, there are a few things you can do to address your symptoms such as trying smaller but more frequent meals of easy-to-eat anti-inflammatory foods and limiting caffeine, alcohol, grains and dairy. Currently, there is no medication for gastric emptying that is compatible with people with Parkinsons, but you can talk to your doctor and your nutritionist about other possible strategies and treatments.

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What Causes Parkinson Disease

Parkinson disease arises from decreased dopamine production in the brain. The absence of dopamine makes it hard for the brain to coordinate muscle movements. Low dopamine also contributes to mood and cognitive problems later in the course of the disease. Experts don’t know what triggers the development of Parkinson disease most of the time. Early onset Parkinson disease is often inherited and is the result of certain gene defects.

Energy Homeostatic Centers Dysfunction

Apart from hypothalamus, the locus coreruleus is also thought to be an important homeostatic control center , which interacts with hypothalamus via afferent and efferent fibers. LC degeneration has been observed in human postmortem studies . The effect of LC degeneration on weight change in PD was corroborated in the 6-OHDA rat model . According to the study, weight loss was observed only in rat with lesion of the LC and striatum compared to lesion of striatum alone, while chronic DBS-STN abolished the weight variation.

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Weight Changes In Parkinsons Disease

PD may cause a person to gain weight or to lose weight. Changes to weight can have negative effects on a persons overall health. Weight gain, which may occur due to lack of movement and exercise, can lead to being overweight. This increases the risk of heart disease and high blood pressure and puts extra stress on joints.2,3

Weight loss can lead to losing muscle mass and strength. This may increase the risk of infection or osteoporosis. Progressive, unintended weight loss is a major feature of the progression of PD.2,3

There are several strategies that can help people with PD to manage their weight. This includes eating a balanced diet with a variety of foods and getting regular exercise. A doctor or registered dietitian can provide specific strategies aimed at either gaining or losing weight.3

Pharmacotherapies For The Treatment Of Neuropsychiatric Symptoms Of Dementia And Their Effect On Body Weight

Parkinson’s Dementia

As aforementioned, AChEIs and NMDAR antagonists are the only medications with marketing approval for the treatment of dementia . However, several other medications are prescribed to treat concomitant neuropsychiatric symptoms. These symptoms are referred to as behavioral and psychological symptoms of dementia . These symptoms occur irrespective of dementia subtype and include a wide array of non-cognitive disturbances such as agitation, aggression, hallucinations, and depression . Behavioral and psychological symptoms of dementia are associated with high levels of distress and poor outcomes for the patient and caregiver, as well as increased use of healthcare resources . Behavioral and psychological symptoms of dementia are therefore a meaningful intervention target and unexpected benefits may arise from BPSD medications. For example, dronabinol, a synthetic cannabinoid used to decrease nausea and improve appetite in patients with human immunodeficiency virus, is used as an off-label treatment for BPSD-related aggression and agitation in the elderly. Interestingly, a placebo-controlled crossover study and a non-randomized retrospective study also suggest that it may alleviate anorexia . However, BW did not change in a more recent RCT , hence it is not yet possible to draw conclusions. Herein, antidepressants and antipsychotics are briefly discussed as they are more frequently used as an off-label treatment for BPSD.

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‘kicked Into High Gear’

Among patients already diagnosed with Alzheimer’s-related dementia, rapid weight loss has long been associated with faster disease progression. But the course of weight loss prior to the development of memory loss and other symptoms of dementia has not been well understood.

The researchers used data from the Memory and Aging Project at the Alzheimer’s Disease Research Center of Washington University in St. Louis, which is a long-term study assessing the impact of aging on the brain.

The study included 449 healthy adults between the ages of 65 and 95 with no clinical evidence of Alzheimer’s-associated dementia at enrollment. The study participants were followed for an average of six years, during which time they were weighed and assessed for dementia annually.

During the study, 125 people developed dementia related to Alzheimer’s disease. Those who did weighed an average of 8 pounds less than those who didn’t at the beginning of the study.

The two groups tended to lose weight at the same rate of about 0.6 pounds a year for several years. But a year before early signs of dementia were first seen, the future Alzheimer’s patients lost twice as much weight as the patients who didn’t develop Alzheimer’s.

“No matter what we did to control for other health variables, such as diabetesdiabetes, strokestroke, and hypertensionhypertension, none of them could account for this effect,” Johnson says.

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