パーキンソン病の栄養状態の疫学2

パーキンソン病の栄養状態を調査した論文をもう1つ紹介します。中国からの論文です。

Wang G, Wan Y, Cheng Q, Xiao Q, Wang Y, Zhang J, Ma JF, Wang XJ, Zhou HY, Chen SD. Malnutrition and associated factors in Chinese patients with Parkinson's disease: Results from a pilot investigation. Parkinsonism Relat Disord. 2010 Feb;16(2):119-23.

外来のパーキンソン病患者117人についてMNAで栄養評価したところ、低栄養が1.71%、低栄養のおそれありが19.66％でした。便秘と抑うつが最も重要な低栄養の予測因子と考えられました。

この論文でもパーキンソン病で低栄養の方はこんなに少ないのか、という印象です。外来患者であることと、HｰY分類でⅠ：48人、Ⅱ：42人、Ⅲ：23人、Ⅳ：4人と軽度の方が多いことが原因だと思います。嚥下障害の方も22.5%しかいませんし、嚥下障害も軽度の方が多いのではと推測します。

抑うつはよくわかりますが、便秘が低栄養と関連しているのは見落とされがちな気がします。吐気、下痢だけでなく便秘対策も栄養管理では重要だと改めて感じました。

Abstract
OBJECTIVE: This study was conducted to evaluate the prevalence of malnutrition among patients with Parkinson's disease (PD) and determine the associations between malnutrition and non-motor symptoms (NMS).

METHODS: We conducted a cross-sectional assessment of 117 consecutive outpatients with PD and their respective caregivers. The participants were interviewed and assessed using various scales, including the Mini Nutritional Assessment (MNA), Non-Motor Symptoms questionnaire for Parkinson's disease (NMS quest), Mini-mental State Examination (MMSE), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Geriatric Depression Scale (GDS), and Hamilton Anxiety Scale (HAMA). We also investigated the socio-demographic characteristics of the subjects.

RESULTS: The prevalence of malnutrition (MNA score < 17) was 1.71%, and 19.66% patients were at risk of malnutrition (17
CONCLUSIONS: Nearly 22% of PD patients were malnourished or at the risk of malnutrition and the negative association between NMSs and nutritional care needs to be determined by further studies.