Impact of weight loss for psychiatric symptoms in mid-stage patients with Parkinson's disease: A 4-year follow-up study

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Background: Weight loss is one of non-motor symptoms frequently seen in patients with Parkinson's disease (PwPD); Weight loss in PwPD is known to be negatively associated with motor and other non-motor symptoms, and has been shown to influence the prognosis of PD. Here, we followed weight change over a 4-year period in PwPD in a single institution and investigated the relationship between weight change and patients’ motor and non-motor symptoms. Methods PwPD who visited our hospital from January 2018 to December 2022 were enrolled. Body weight were measured at two points in 2018 (at the start of observation, 'baseline') and 2022 (at the end of observation, 'end date'). In addition, motor symptoms, disease severity, cognitive function, and psychiatric symptoms were evaluated during the same period, and the relationship with weight loss was examined. Results Data of 96 PwPD were available for a 4-year period follow-up. At baseline, mean age was 65.7 ± 10.0 years, mean disease duration was 6.8 ± 4.0 years, and mean Hoehn and Yahr stage was 2.4 ± 0.7. Among them, 49 patients (51.0%) had a weight loss of ≥ 5% from baseline (weight loss group; mean loss was 6.4 ± 3.6 kg). The weight loss group was older ( P  = 0.045), had a lower Mini-Mental State Examination (MMSE) at baseline ( P  = 0.037), and had a significantly lower body mass index ( P  = 0.001) and higher Zung Self-Rating Depression Scale (SDS) ( P  = 0.012) at end date. There was a negative correlation (γ = -0.403, P  < 0.001) between weight change and age, a positive correlation (γ = 0.318, P  = 0.002) between weight change and MMSE at baseline, and a negative correlation (γ = -0.333, P  = 0.001) between weight change and SDS at end date. Age-adjusted correlations showed a final negative correlation (γ = -0.309, P  = 0.002) between weight change and SDS. Conclusions Weight loss in PwPD in mid-stage was more likely with increasing age, and a ≥ 5% weight loss was associated with worsening depression. Further research is needed regarding the significance of weight loss in PwPD. Trial registration The participants were retrospectively registered.

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