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Parkinson’s Disease, Nutrition, and Surgery in Context of Critical Care

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Diet and Nutrition in Critical Care

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Abstract

Parkinson’s disease is a common neurodegenerative disorder with a higher risk of hospitalization than the general population. Therefore, there is a high likelihood of encountering a person with Parkinson’s disease in acute or critical care. Most people with Parkinson’s disease are over the age of 60 years and are likely to have other concurrent medical conditions. Parkinson’s disease is more likely to be the secondary diagnosis during hospital admission. The primary diagnosis may be due to other medical conditions or as a result of complications from Parkinson’s disease symptoms. Symptoms include motor symptoms, such as slowness of movement and tremor, and non-motor symptoms, such as depression, dysphagia, and constipation. There is a large degree of variation in the presence and degree of symptoms as well as in the rate of progression. There is a range of medications that can be used to manage the motor or non-motor symptoms, and side effects can occur. Improper administration of medications can result in deterioration of the patient’s condition and potentially a life-threatening condition called neuroleptic malignant-like syndrome. Nutrients and delayed gastric emptying may also interfere with intestinal absorption of levodopa, the primary medication used for motor symptom management. Rates of protein-energy malnutrition can be up to 15 % in people with Parkinson’s disease in the community, and this is likely to be higher in the acute or critical care setting. Nutrition-related care in this setting should utilize the Nutrition Care Process and take into account each individual’s Parkinson’s disease motor and non-motor symptoms, the severity of disease, limitations due to the disease, medical management regimen, and nutritional status when planning nutrition interventions. Special considerations may need to be taken into account in relation to meal and medication times and the administration of enteral feeding. Nutrition screening, assessment, and monitoring should occur on a regular basis during admission to minimize effects on Parkinson’s disease symptoms and to optimize nutrition-related outcomes.

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Abbreviations

COMT:

Catechol-O-methyltransferase

DBS:

Deep brain stimulation

GPi:

Globus pallidus internus

H&Y:

Hoehn and Yahr

IBW:

Ideal body weight

ICU:

Intensive care unit

MAO:

Monoamine oxidase inhibitor

MNA:

Mini-Nutritional Assessment

MST:

Malnutrition Screening Tool

MUST:

Malnutrition Universal Screening Tool

NCP:

Nutrition care process

NMDA:

N-Methyl-d-aspartic acid

NMLS:

Neuroleptic malignant-like syndrome

PD:

Parkinson’s disease

PEG:

Percutaneous gastrostomy

PG-SGA:

Patient-Generated Subjective Global Assessment

PPN:

Pedunculopontine nucleus

PRD:

Protein redistribution diet

SGA:

Subjective Global Assessment

STN:

Subthalamic nucleus

References

  • Ahlskog JE, Muenter MD. Frequency of levodopa-related dyskinesias and motor fluctuations as estimated from the cumulative literature. Mov Disord. 2001;16:448–58.

    Article  CAS  PubMed  Google Scholar 

  • Bachmann CG, Zapf A, Brunner E, et al. Dopaminergic treatment is associated with decreased body weight in patients with Parkinson’s disease and dyskinesias. Eur J Neurol. 2009;16:895–901.

    Article  CAS  PubMed  Google Scholar 

  • Barichella M, Marczewska A, De Notaris R, et al. Special low-protein foods ameliorate postprandial off in patients with advanced Parkinson’s disease. Mov Disord. 2006;21:1682–7.

    Article  PubMed  Google Scholar 

  • Barichella M, Villa MC, Massarotto A, et al. Mini nutritional assessment in patients with Parkinson’s disease: correlation between worsening of the malnutrition and increasing number of disease years. Nutr Neurosci. 2008;11:128–34.

    Article  PubMed  Google Scholar 

  • Baroni L, Bonetto C, Tessan F, et al. Pilot dietary study with normoproteic protein-redistributed plant-food diet and motor performance in patients with Parkinson’s disease. Nutr Neurosci. 2011;14:1–9.

    Article  CAS  PubMed  Google Scholar 

  • Baruzzi A, Contin M, Riva R, et al. Influence of meal ingestion time on pharmacokinetics of orally administered LevoDOPA in Parkinsonian patients. Clin Neuropharmacol. 1987;10:527–37.

    Article  CAS  PubMed  Google Scholar 

  • Bernal-Pacheco O, Limotai N, Go CL, et al. Nonmotor manifestations in Parkinson disease. Neurologist. 2012;18:1–16.

    Article  PubMed  Google Scholar 

  • Beyer MK, Herlofson K, Arsland D, et al. Causes of death in a community-based study of Parkinson’s disease. Acta Neurol Scand. 2001;103:7–11.

    Article  CAS  PubMed  Google Scholar 

  • Bohé J, Low A, Wolfe RR, et al. Human muscle protein synthesis is modulated by extracellular, not intramuscular amino acid availability: a dose-response study. J Physiol. 2003;552:315–24.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bonnici A, Ruiner C-E, St-Laurent L, et al. An interaction between levodopa and enteral nutrition resulting in neuroleptic malignant-like syndrome and prolonged ICU stay. Ann Pharmacother. 2010;44:1504–7.

    Article  PubMed  Google Scholar 

  • Bracco F, Malesani R, Saladini M, et al. Protein redistribution diet and antiparkinsonian response to levodopa. Eur Neurol. 1991;31:68–71.

    Article  CAS  PubMed  Google Scholar 

  • Brennan K. Managing Parkinson’s disease during surgery. BMJ. 2010;341:c5718.

    Article  CAS  PubMed  Google Scholar 

  • Cereda E, Barichella M, Pedrolli C. Low-protein and protein-redistribution diets for Parkinson’s disease patients with motor fluctuations: a systematic review. Mov Disord. 2010;25:2021–34.

    Article  PubMed  Google Scholar 

  • Chen H, Zhang SM, Hernán MA, et al. Weight loss in Parkinson’s disease. Ann Neurol. 2003;53:676–9.

    Article  PubMed  Google Scholar 

  • Chou KL, Zamudio J, Schmidt P, et al. Hospitalization in Parkinson disease: a survey of National Parkinson Foundation Centers. Parkinsonism Relat Disord. 2011;17:440–5.

    Article  PubMed Central  PubMed  Google Scholar 

  • Coelho M, Marti MJ, Tolosa E, et al. Late-stage Parkinson’s disease: the Barcelona and Lisbon cohort. J Neurol. 2010;257:1524–32.

    Article  PubMed  Google Scholar 

  • Cooper MK, Brock DG, McDaniel CM. Interaction between levodopa and enteral nutrition. Ann Pharmacother. 2008;42:439–42.

    Article  CAS  PubMed  Google Scholar 

  • Croxson S, Johnson B, Millac P, et al. Dietary modification of Parkinson’s disease. Eur J Clin Nutr. 1991;45:263–6.

    CAS  PubMed  Google Scholar 

  • Cuthbertson D, Smith K, Babraj J, et al. Anabolic signaling deficits underlie amino acid resistance of wasting, aging muscle. FASEB J. 2005;19:422–4.

    CAS  PubMed  Google Scholar 

  • De Lau LML, Breteler MMB. Epidemiology of Parkinson’s disease. Lancet Neurol. 2006;5:525–35.

    Article  PubMed  Google Scholar 

  • Detsky AS, McLaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987;11:8–13.

    Article  CAS  PubMed  Google Scholar 

  • Dorsey E, Thompson R, Constantinescu J, et al. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology. 2007;68:384–6.

    Article  CAS  PubMed  Google Scholar 

  • Elia M. Development and use of the malnutrition universal screening tool (‘MUST’) for adults. In: Screening for malnutrition: a multidisciplinary responsibility. Redditch, UK: British Association for Parenteral and Enteral Nutrition; 2003. p. 51–107.

    Google Scholar 

  • Encarnacion EV, Hauser RA. Levodopa-induced dyskinesias in Parkinson’s disease: etiology, impact on quality of life, and treatments. Eur Neurol. 2008;60:57–66.

    Article  CAS  PubMed  Google Scholar 

  • Fasano A, Daniele A, Albanese A. Treatment of motor and non-motor features of Parkinson’s disease with deep brain stimulation. Lancet Neurol. 2012;11:429–42.

    Article  PubMed  Google Scholar 

  • Ferguson M, Capra S, Bauer J, et al. Development of a valid and reliable malnutrition screening tool for adult acute hospital patients. Nutrition. 1999;15:458–64.

    Article  CAS  PubMed  Google Scholar 

  • Freeman WD, Tan KM, Glass GA, et al. ICU management of patients with Parkinson’s disease or Parkinsonism. Curr Anaesth Crit Care. 2007;18:227–36.

    Article  Google Scholar 

  • Gerlach OHH, Winogrodzka A, Weber WEJ. Clinical problems in the hospitalized Parkinson’s disease patient: systematic review. Mov Disord. 2011;26:197–208.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gerlach OHH, Broen MPG, Van Domburg PHMF, et al. Deterioration of Parkinson’s disease during hospitalization: survey of 684 patients. BMC Neurol. 2012;12:13.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gimenez-Roldan S, Mateo D. Predicting beneficial response to a protein-redistribution diet in fluctuating Parkinson’s disease. Acta Neurol Belg. 1991;91:189–200.

    CAS  PubMed  Google Scholar 

  • Goetz G, Poewe W, Rascol O, et al. Movement disorder society task force report on the Hoehn and Yahr staging scale; status and recommendations. Mov Disord. 2004;19:1020–8.

    Article  PubMed  Google Scholar 

  • Gordon PH, Frucht SJ. Neuroleptic malignant syndrome in advanced Parkinson’s disease. Mov Disord. 2001;16:960–74.

    Article  CAS  PubMed  Google Scholar 

  • Green K. Best practice guideline for dietitians on the management of Parkinson’s. Birmingham, UK: British Dietetic Association; 2010.

    Google Scholar 

  • Guttman M, Slaughter PM, Theriault M-E, et al. Burden of parkinsonism: a population-based study. Mov Disord. 2003;18:313–9.

    Article  PubMed  Google Scholar 

  • Guttman M, Slaughter PM, Theriault M-E, et al. Parkinsonism in Ontario: comorbidity associated with hospitalization in a large cohort. Mov Disord. 2004;19:49–53.

    Article  PubMed  Google Scholar 

  • Harada T, Mitsuoka K, Kumagai R, et al. Clinical features of malignant syndrome in Parkinson’s disease and related neurological disorders. Parkinsonism Relat Disord. 2003;9:15–23.

    Article  Google Scholar 

  • Hely MA, Morris JGL, Reid WGJ, et al. Sydney multicenter study of Parkinson’s disease: non-l-dopa-responsive problems dominate at 15 years. Mov Disord. 2005;20:190–9.

    Article  PubMed  Google Scholar 

  • Ikebe S, Harada T, Hashimoto T, et al. Prevention and treatment of malignant syndrome in Parkinson’s disease: a consensus statement of the malignant syndrome research group. Parkinsonism Relat Disord. 2003;9:47–9.

    Article  Google Scholar 

  • Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13:782–8.

    Article  CAS  PubMed  Google Scholar 

  • Katsanos CS, Kobayashi H, Sheffield-Moore M, et al. Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids. Am J Clin Nutr. 2005;82:1065–73.

    CAS  PubMed  Google Scholar 

  • Lacey K, Pritchett E. Nutrition care process and model: ADA adopts road map to quality care and outcomes management. J Am Diet Assoc. 2003;103:1061–72.

    Article  PubMed  Google Scholar 

  • Lang AE. A critical appraisal of the premotor symptoms of Parkinson’s disease: potential usefulness in early diagnosis and design of neuroprotective trials. Mov Disord. 2011;26:775–83.

    Article  PubMed  Google Scholar 

  • Leopold NA, Polansky M, Hurka MR. Drug adherence in Parkinson’s disease. Mov Disord. 2004;19:513–7.

    Article  PubMed  Google Scholar 

  • Lorefält B, Toss G, Granérus A-K. Weight loss, body fat mass, and leptin in Parkinson’s disease. Mov Disord. 2009;24:885–90.

    Article  PubMed  Google Scholar 

  • Magdalinou KN, Martin A, Kessel B. Prescribing medications in Parkinson’s disease (PD) patients during acute admissions to a district general hospital. Parkinsonism Relat Disord. 2007;13:539–40.

    Article  PubMed  Google Scholar 

  • Mena I, Cotzias GC. Protein intake and treatment of Parkinson’s disease with levodopa. N Engl J Med. 1975;292:181–4.

    Article  CAS  PubMed  Google Scholar 

  • Micieli G, Tosi P, Marcheselli S, et al. Autonomic dysfunction in Parkinson’s disease. Neurol Sci. 2003;24:S32–4.

    Article  PubMed  Google Scholar 

  • Montaurier C, Morio B, Bannier S, et al. Mechanisms of body weight gain in patients with Parkinson’s disease after subthalamic stimulation. Brain. 2007;130:1808–18.

    Article  CAS  PubMed  Google Scholar 

  • Nutt J, Fellman JH. Pharmacokinetics of levodopa. Clin Neuropharmacol. 1984;7:35–49.

    Article  CAS  PubMed  Google Scholar 

  • Ottery F. Patient-generated subjective global assessment. In: McCallum PD, editor. The clinical guide to oncology nutrition. Chicago: American Dietetic Association; 2000. p. 11–23.

    Google Scholar 

  • Paddon-Jones D, Rasmussen BB. Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care. 2009;12:86–90.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Pare S, Barr SI, Ross SE. Effect of daytime protein restriction on nutrient intakes of free- living Parkinson’s disease patients. Am J Clin Nutr. 1992;55:701–7.

    CAS  PubMed  Google Scholar 

  • Pepper P, Goldstein M. Postoperative complications in Parkinson’s disease. J Am Geriatr Soc. 1999;47:967–72.

    CAS  PubMed  Google Scholar 

  • Riley D, Lang AE. Practical application of a low-protein diet for Parkinson’s disease. Neurology. 1988;38:1026–31.

    Article  CAS  PubMed  Google Scholar 

  • Schapira AHV, Emre M, Jenner P, et al. Levodopa in the treatment of Parkinson’s disease. Eur J Neurol. 2009;16:982–9.

    Article  CAS  PubMed  Google Scholar 

  • Sheard JM, Ash S, Mellick GD, et al. Malnutrition in a sample of community-dwelling people with Parkinson’s disease. PLoS ONE. 2013a;8:e53290.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Sheard JM, Ash S, Mellick GD, et al. Markers of disease severity are associated with malnutrition in Parkinson’s disease. PLoS ONE. 2013b;8:e57986.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Silburn PA, Mellick GD, Vieira BI, et al. Utility of a patient survey in identifying fluctuations in early stage Parkinson’s disease. J Clin Neurosci. 2008;15:1235–9.

    Article  CAS  PubMed  Google Scholar 

  • Symons TB, Schutzler SE, Cocke TL, et al. Aging does not impair the anabolic response to a protein-rich meal. Am J Clin Nutr. 2007;86:451–6.

    CAS  PubMed  Google Scholar 

  • Symons TB, Sheffield-Moore M, Wolfe RR, et al. A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects. J Am Diet Assoc. 2009;109:1582–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Temlett JA, Thompson PD. Reasons for admission to hospital for Parkinson’s disease. Intern Med J. 2006;36:524–6.

    Article  CAS  PubMed  Google Scholar 

  • Uc EY, Struck LK, Rodnitzky RL, et al. Predictors of weight loss in Parkinson’s disease. Mov Disord. 2006;21:930–6.

    Article  PubMed  Google Scholar 

  • Ueda M, Hamamoto M, Nagayama H, et al. Susceptibility to neuroleptic malignant syndrome in Parkinson’s disease. Neurology. 1999;52:777–81.

    Article  CAS  PubMed  Google Scholar 

  • Wang G, Wan Y, Cheng Q, et al. Malnutrition and associated factors in Chinese patients with Parkinson’s disease: results from a pilot investigation. Parkinsonism Relat Disord. 2010;16:119–23.

    Article  PubMed  Google Scholar 

  • White JV, Guenter P, Jensen G, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Acad Nutr Diet. 2012;112:730–8.

    Article  PubMed  Google Scholar 

  • Woodford H, Walker R. Emergency hospital admissions in idiopathic Parkinson’s disease. Mov Disord. 2005;20:1104–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, 4059, Brisbane, QLD, Australia

    Jamie M. Sheard & Susan Ash

Authors
  1. Jamie M. Sheard
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  2. Susan Ash
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Correspondence to Jamie M. Sheard .

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Editors and Affiliations

  1. Department of Nutrition, King's College London, London, United Kingdom

    Rajkumar Rajendram

  2. School of Medicine, King's College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Sheard, J.M., Ash, S. (2014). Parkinson’s Disease, Nutrition, and Surgery in Context of Critical Care. In: Rajendram, R., Preedy, V., Patel, V. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8503-2_51-1

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  • DOI: https://doi.org/10.1007/978-1-4614-8503-2_51-1

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