Skip to main content

Advertisement

SpringerLink
Log in

Malnutrition and Neurodegenerative Diseases

  • Neurological Disease and Cognitive Function (G Logroscino, Section Editor)
  • Published:
Current Nutrition Reports Aims and scope Submit manuscript

Abstract

With the aging population, the prevalence of the two most common neurodegenerative disorders, namely Parkinson’s disease and Alzheimer’s disease, is likely to increase. Given the presence of disease symptoms that are also risk factors for poor nutritional status, weight loss and malnutrition are commonly reported as issues. However, a consensus has not been reached regarding the prevalence and significance of poor nutritional status. Using validated nutrition screening and assessment tools, 14.1–55.9% and 0–12.6% of people with mild Alzheimer’s disease are at risk of malnutrition and malnourishment, respectively, while 17.2–23.5% and 0–40% of people with mild to severe Parkinson’s disease are at risk of malnutrition and malnourishment, respectively. Disease-specific factors are predictive of nutritional status, and greater disease severity is particularly important. Nutrition intervention data are lacking, but needed, for both diseases. Nutrition screening should occur early in the disease by health professionals with regular patient contact.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. White JV, Guenter P, Jensen G, Malone A, Schofield M, Academy Malnutrition Work Group, 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. Consensus has been lacking regarding the definition and diagnosis of malnutrition. This statement by two of the leading organizations for adult nutrition provides guidance for the parameters and definitions for malnutrition in adults.

    Article  PubMed  Google Scholar 

  2. Visvanathan R, Macintosh C, Callary M, Penhall R, Horowitz M, Chapman I. The nutritional status of 250 older Australian recipients of domiciliary care services and its association with outcomes at 12 months. J Am Geriatr Soc. 2003;51:1007–11.

    Article  PubMed  Google Scholar 

  3. Leggo M, Banks M, Isenring E, Stewart L, Tweeddale M. A quality improvement nutrition screening and intervention program available to Home and Community Care eligible clients. Nutr Diet. 2008;65:162–7.

    Article  Google Scholar 

  4. Davidson J, Getz M. Nutritional risk and body composition in free-living elderly participating in congregate meal-site programs. J Nutr Elder. 2008;24:53–68.

    Article  Google Scholar 

  5. Johansson Y, Bachrach-Lindström M, Carstensen J, Ek A. Malnutrition in a home-living older population: prevalence, incidence and risk factors. A prospective study. J Clin Nurs. 2009;18:1354–64.

    Article  PubMed  Google Scholar 

  6. Pai MK. Comparative study of nutritional status of elderly population living in the home for aged vs those living in the community. Biomed Res. 2011;22:120–6.

    Google Scholar 

  7. Rist G, Miles G, Karimi L. The presence of malnutrition in community-living older adults receiving home nursing services. Nutr Diet. 2012;69:46–50.

    Article  Google Scholar 

  8. Milne AC, Potter J, Vivanti A, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev. Cochrane Database Syst Rev. 2009. doi:10.1002/14651858.CD003288.pub3.

    PubMed  Google Scholar 

  9. Neumann SA, Miller MD, Daniels L, Crotty M. Nutritional status and clinical outcomes of older patients in rehabilitation. J Hum Nutr Diet. 2005;18:129–36.

    Article  PubMed  CAS  Google Scholar 

  10. Correia MITD, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22:235–9.

    Article  PubMed  Google Scholar 

  11. Guest JF, Panca M, Baeyens J-P, de Man F, Ljungqvist O, Pichard C, et al. Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK. Clin Nutr. 2011;30:422–9.

    Article  PubMed  Google Scholar 

  12. Banks MD, Graves N, Bauer JD, Ash S. Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals. Eur J Clin Nutr. 2013;67:42–6.

    Article  PubMed  CAS  Google Scholar 

  13. Wikby K, Ek A-C, Christensson L. Nutritional status in elderly people admitted to community residential homes: comparisons between two cohorts. J Nutr Health Aging. 2006;10:232–8.

    PubMed  CAS  Google Scholar 

  14. Atlantis E, Browning C, Kendig H. Body mass index and unintentional weight change associated with all-cause mortality in older Australians: The Melbourne Longitudinal Studies on Healthy Ageing (MELSHA). Age Ageing. 2010;39:559–65.

    Article  Google Scholar 

  15. Bannerman E, Miller MD, Daniels LA, Cobiac L, Giles LC, Whitehead C, et al. Anthropometric indices predict physical function and mobility in older Australians: The Australian Longitudinal Study of Ageing. Public Health Nutr. 2002;5:655–62.

    Article  PubMed  Google Scholar 

  16. Mirarefin M, Sharifi F, Fakhrzadeh H, Nazari N, Ghaderpanahi M, Badamchizade Z, et al. Predicting the value of the mini nutritional assessment (MNA) as an indicator of functional ability in older Iranian adults (Kahrizak elderly study). J Nutr Health Aging. 2011;15:175–80.

    Article  PubMed  CAS  Google Scholar 

  17. Vivanti AP, McDonald CK, Palmer MA, Sinnott M. Malnutrition associated with increased risk of frail mechanical falls among older people presenting to an emergency department. Emerg Med Australas. 2009;21:386–94.

    Article  PubMed  Google Scholar 

  18. Meijers JMM, Halfens RJG, Neyens JCL, Luiking YC, Verlaan G, Schols JMGA. Predicting falls in elderly receiving home care: the role of malnutrition and impaired mobility. J Nutr Health Aging. 2012;16:654–8.

    Article  PubMed  CAS  Google Scholar 

  19. Ülger Z, Halil M, Kalan I, Yavuz BB, Cankurtaran M, Güngör E, et al. Comprehensive assessment of malnutrition risk and related factors in a large group of community-dwelling older adults. Clin Nutr. 2010;29:507–11.

    Article  PubMed  Google Scholar 

  20. Feldblum I, German L, Castel H, Harman-Boehm I, Bilenko N, Eisinger M, et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J. 2007;6:37–44.

    Article  PubMed Central  PubMed  Google Scholar 

  21. German L, Kahana C, Rosenfeld V, Zabrowsky I, Wiezer Z, Fraser D, et al. Depressive symptoms are associated with food insufficiency and nutritional deficiencies in poor community-dwelling elderly people. J Nutr Health Aging. 2011;15:3–8.

    Article  PubMed  Google Scholar 

  22. Olin AÖ, Koochek A, Ljungqvist O, Cederholm T. Nutritional status, well-being and functional ability in frail elderly service flat residents. Eur J Clin Nutr. 2005;59:263–70.

    Article  Google Scholar 

  23. Elia M, Stratton RJ. Geographical inequalities in nutrient status and risk of malnutrition among English people aged 65 y and older. Nutrition. 2005;21:1100–6.

    Article  PubMed  Google Scholar 

  24. Mamhidir AG, Ljunggren G, Kihlgren M, Kihlgren A, Wimo A. Underweight, weight loss and related risk factors among older adults in sheltered housing - a Swedish follow-up study. J Nutr Health Aging. 2006;10:255–63.

    PubMed  CAS  Google Scholar 

  25. Johansson G. Comparison of nutrient intake between different dietary assessment methods in elderly male volunteers. Nutr Diet. 2008;65:266–71.

    Article  Google Scholar 

  26. Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature–What does it tell us? J Nutr Health Aging. 2006;10:466–85.

    PubMed  CAS  Google Scholar 

  27. Chang C-C, Roberts BL. Feeding difficulty in older adults with dementia. J Clin Nurs. 2008;17:2266–74.

    Article  PubMed  Google Scholar 

  28. Position Paper of the American Dietetic Association: nutrition across the spectrum of aging. J Am Diet Assoc. 2005;105:616–633.

    Google Scholar 

  29. Saka B, Kaya O, Ozturk GB, Erten N, Karan MA. Malnutrition in the elderly and its relationship with other geriatric syndromes. Clin Nutr. 2010;29:745–8.

    Article  PubMed  Google Scholar 

  30. St-Arnaud-McKenzie D, Payette H, Gray-Donald K. Low physical function predicts either 2-year weight loss or weight gain in healthy community-dwelling older adults. The NuAge longitudinal study. J Gerontol A Biol Sci Med Sci. 2010;65A:1362–8.

    Article  Google Scholar 

  31. Hughes G, Bennett KM, Hetherington MM. Old and alone: barriers to healthy eating in older men living on their own. Appetite. 2004;43:269–76.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  33. Malnutrition Advisory Group. Development and use of the malnutrition universal screening tool (’MUST') for adults. Screening for Malnutrition: A Multidisciplinary Responsibility. In: Elia M, editor. Screen. Malnutrition A Multidiscip. Responsib. Redditch, U: British Association for Parenteral and Enteral Nutrition; 2003. p. 51–107.

    Google Scholar 

  34. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: Developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56A:M366–73.

    Article  Google Scholar 

  35. 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  PubMed  CAS  Google Scholar 

  36. Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: a practical assessment for grading the nutritional state of elderly patients. Facts Res Gerontol. 1994;15–59.

  37. Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA. What is subjective global assessment of nutritional status? JPEN J Parenter Enter Nutr. 1987;11:8–13.

    Article  CAS  Google Scholar 

  38. Ottery F. Patient-Generated Subjective Global Assessment. The Clinical Guide to Oncology Nutrition. In: McCallum PD, editor. Clin. Guid. to Oncol. Nutr. Chicago: American Dietetic Association; 2000. p. 11–23.

    Google Scholar 

  39. Barichella M, Cereda E, Pezzoli G. Major nutritional issues in the management of Parkinson’s disease. Mov Disord. 2009;24:1881–92.

    Article  PubMed  Google Scholar 

  40. Belmin J. The Members of the Expert Panel and Organisation Committee. Practical guidelines for the diagnosis and management of weight loss in Alzheimer’s disease: a consensus from appropriateness ratings of a large expert panel. J Nutr Health Aging. 2007;11:33–7.

    PubMed  CAS  Google Scholar 

  41. Gillette-Guyonnet S, Abellan van Kan G, Alix E, et al. IANA (International Academy on Nutrition and Aging) Expert Group: weight loss and Alzheimer’s disease. J Nutr Health Aging. 2007;11:38–48.

    PubMed  CAS  Google Scholar 

  42. Sheard JM, Ash S, Silburn PA, Kerr GK. Prevalence of malnutrition in Parkinson’s disease: a systematic review. Nutr Rev. 2011;69:520–32.

    Article  PubMed  Google Scholar 

  43. Ousset P-J, Nourhashemi F, Reynish E, Vellas B. Nutritional status is associated with disease progression in very mild Alzheimer disease. Alzheimer Dis Assoc Disord. 2008;22:66–71.

    Article  PubMed  Google Scholar 

  44. Gillioz A-S, Villars H, Voisin T, et al. Spared and impaired abilities in community-dwelling patients entering the severe stage of Alzheimer’s disease. Dement Geriatr Cogn Disord. 2009;28:427–32.

    Article  PubMed  Google Scholar 

  45. Spaccavento S, Del Prete M, Craca A, Fiore P. Influence of nutritional status on cognitive, functional and neuropsychiatric deficits in Alzheimer’s disease. Arch Gerontol Geriatr. 2009;48:356–60.

    Article  PubMed  Google Scholar 

  46. Bilotta C, Bergamaschini L, Arienti R, Spreafico S, Vergani C. Caregiver burden as a short-term predictor of weight loss in older outpatients suffering from mild to moderate Alzheimer’s disease: a three months follow-up study. Aging Ment Health. 2010;14:481–8.

    Article  PubMed  Google Scholar 

  47. Saragat B, Buffa R, Mereu E, Succa V, Cabras S, Mereu RM, et al. Nutritional and psycho-functional status in elderly patients with Alzheimer’s disease. J Nutr Health Aging. 2011;16:231–6.

    Article  Google Scholar 

  48. Droogsma E, Van Asselt D, Scholzel-Dorenbos C, Van Steijn J, Van Walderveen P, Van der Hooft C. Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer’s disease: prevalence of malnutrition. J Nutr Health Aging. 2013;17:606–10. This paper, using the MNA, highlights the fact that people with Alzheimer’s disease living in the community are at risk of malnutrition, even when first diagnosed, indicating a need for nutrition screening as early as diagnosis.

    Article  PubMed  CAS  Google Scholar 

  49. Salva A, Andrieu S, Fernandez E, Schiffrin E, Moulin J, Decarli B, et al. Health and nutritional promotion program for patients with dementia (NutriAlz Study): design and baseline data. J Nutr Health Aging. 2009;14:78.

    Article  Google Scholar 

  50. Isaia G, Mondino S, Germinara C, Cappa G, Aimonino-Ricauda N, Bo M, et al. Malnutrition in an elderly demented population living at home. Arch Gerontol Geriatr. 2011;53:249–51.

    Article  PubMed  Google Scholar 

  51. Guérin O, Andrieu S, Schneider SM, Cortes F, Cantet C, Gillette-Guyonnet S, et al. Characteristics of Alzheimer’s disease patients with a rapid weight loss during a six-year follow-up. Clinical. 2009;28:141–6.

    Google Scholar 

  52. Salvà A, Andrieu S, Fernandez E, Schiffrin EJ, Moulin J, Decarli B, et al. Health and nutrition promotion program for patients with dementia (NutriAlz): cluster randomized trial. J Nutr Health Aging. 2011;15:822–30.

    Article  PubMed  Google Scholar 

  53. Cortes F, Portet F, Touchon J, Vellas B, Real.Fr Group. Six and 18-month changes in mild to moderate Alzheimer’s patients treated with acetylcholinesterase inhibitors: what can we learn for clinical outcomes of therapeutic trials? J Nutr Health Aging. 2007;11:330–7.

    PubMed  CAS  Google Scholar 

  54. Riccio D, Solinas A, Astara G, Mantovani G. Comprehensive geriatric assessment in female elderly patients with Alzheimer disease and other types of dementia. Arch Gerontol Geriatr. 2007;S1:343–53.

    Article  Google Scholar 

  55. Ikeda M, Brown J, Holland AJ, Fukuhara R, Hodges JR. Changes in appetite, food preference, and eating habits in frontotemporal dementia and Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2002;73:371–376.

    Google Scholar 

  56. Vidoni ED, Townley RA, Honea RA, Burns JM. Alzheimer disease biomarkers are associated with body mass index. Neurology. 2011;77:1913–20.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  57. Lauque S, Arnaud-Battandier F, Gillette S, Plaze J-M, Andrieu S, Cantet C, et al. Improvement of weight and fat-free mass with oral nutritional supplementation in patients with Alzheimer’s disease at risk of malnutrition: a prospective randomized study. J Am Geriatr Soc. 2004;52:1702–7.

    Article  PubMed  Google Scholar 

  58. Sheard JM, Ash S. Current practice in nutrition assessment for the management of Parkinson’s disease in Australia and Canada. Nutr Diet. 2013;Nutr Diet in press:

  59. Sheard JM, Ash S, Mellick GD, Silburn PA, Kerr GK. Nutrition screening and assessment in Parkinson’s disease: a comparison of methods. e-SPEN J. 2013;8:e187–e192.

  60. Barichella M, Villa MC, Massarotto A, Cordara SE, Marczewska A, Vairo 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 

  61. Jaafar AF, Gray WK, Porter B, Turnbull EJ, Walker RW. A cross-sectional study of the nutritional status of community-dwelling people with idiopathic Parkinson’s disease. BMC Neurol. 2010;10:124–9.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Wang G, Wan Y, Cheng Q, Wang Y, Zhang J, Maa J-F, 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 

  63. Barichella M, Cereda E, Madio C, Iorio L, Pusani C, Cancello R, et al. Nutritional risk and gastrointestinal dysautonomia symptoms in Parkinson’s disease outpatients hospitalised on a scheduled basis. Br J Nutr. 2013;110:347–53.

    Article  PubMed  CAS  Google Scholar 

  64. Sheard JM, Ash S, Silburn PA, Kerr GK. Nutritional status in Parkinson’s disease patients undergoing deep brain stimulation surgery: A pilot study. J Nutr Health Aging. 2013;17:148–51.

    Article  PubMed  CAS  Google Scholar 

  65. Sheard JM, Ash S, Mellick GD, Silburn PA, Kerr GK. Malnutrition in a sample of community-dwelling people with Parkinson’s disease. PLoS ONE. 2013;8:e53290.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  66. Pilhatsch M, Kroemer NB, Schneider C, et al. Reduced body mass index in Parkinson’s disease: contribution of comorbid depression. J Nerv Ment Dis. 2013;201:76–9.

    Article  PubMed  Google Scholar 

  67. Barichella M, Akpalu A, Cham M, Privitera G, Cassani E, Cereda E, et al. Nutritional status and dietary habits in Parkinson’s disease patients in Ghana. Nutrition. 2013;29:470–3.

    Article  PubMed  Google Scholar 

  68. Sheard JM, Ash S, Mellick GD, Silburn PA, Kerr GK. Markers of disease severity are associated with malnutrition in Parkinson’s disease. PLoS ONE. 2013;8:e57986. Because this study included a wide range of potential factors related to nutritional status in the first true community-based sample of malnutrition in Parkinson’s disease, it was able to demonstrate that the Parkinson’s disease itself plays an important role in malnutrition.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  69. Post B, Merkus MP, de Haan RJ, Speelman JD, Carpa Study Group. Prognostic factors for the progression of Parkinson’s disease: a systematic review. Mov Disord. 2007;22:1839–51.

    Article  PubMed  Google Scholar 

  70. Capecci M, Petrelli M, Emanuelli B, Millevolte M, Nicolai A, Provinciali L, et al. Rest energy expenditure in Parkinson’s disease: role of disease progression and dopaminergic therapy. Parkinsonism Relat Disord. 2013;19:238–41.

    Article  PubMed  Google Scholar 

  71. Walker RW, Howells AR, Gray WK. The effect of levodopa dose and body weight on dyskinesia in a prevalent population of people with Parkinson’s disease. Parkinsonism Relat Disord. 2010;17:27–9.

    Article  PubMed  Google Scholar 

  72. Barichella M, Madio C, Cassani E, Magris C, Pezzoli G. Oral high-calorie, low-protein supplements in a Parkinson’s disease patient: A case report. Mov Disord. 2010;26:354–5.

    Article  PubMed  Google Scholar 

  73. Siegert S, Hazan D, Szyper-Kravitz M. Severe weight loss in a young Parkinson’ s disease patient: a multidisciplinary approach to diagnosis and treatment. Isr Med Assoc J. 2011;13:189–90.

    PubMed  Google Scholar 

  74. 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 

Download references

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Jamie M. Sheard declares that she has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. 109 W Newberry St, Chattanooga, TN, 37415, USA

    Jamie M. Sheard

Authors
  1. Jamie M. Sheard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jamie M. Sheard.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sheard, J.M. Malnutrition and Neurodegenerative Diseases. Curr Nutr Rep 3, 102–109 (2014). https://doi.org/10.1007/s13668-014-0078-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13668-014-0078-2

Keywords

Search

Navigation