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Malnutrition associated with specific health conditions: Parkinson Disease
Dalvir Kular
Chamberlain College of Nursing
NR 449 Evidence-Based Practice
Prof. Yuliya Malishkin
October 3rd, 2022
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Malnutrition associated with specific health conditions: Parkinson Disease
Introduction and Key Points
The topic I chose to address in this paper is: Malnutrition associated with specific health
conditions. And the question is: How and why does Parkinson’s Disease increase the risk of
malnutrition? (Question number 3). All the health conditions put some effects on our diet and
nutrition. If a person is suffering disease, it will impact the diet and eating habits of that person.
So, it is very important to analyze health conditions when we are observing malnutrition and
problem with eating pattern. Nutrients, proteins, and energy we intake are very important and
essential for life. The poor intake of such diet leads to a poor quality of life, risk of falling ill may
be greater, hospitalization, and recovery time can be longer. When we are talking about
Parkinson disease, we know this is a progressive nervous system disorder that effects on the
movement of the body and further effects on the nutritional status.
Article Search
Sources:
Paul BS, Singh T, Paul G, Jain D, Singh G, Kaushal S, Chhina RS. Prevalence of Malnutrition in
Parkinson's Disease and Correlation with Gastrointestinal Symptoms. Ann Indian Acad Neurol.
2019 Oct-Dec;22(4):447-452. doi: 10.4103/aian.AIAN_349_18. Epub 2019 Oct 25. PMID:
31736567; PMCID: PMC6839331.
The study article is a conducted study based on specific methods and find out some
conclusions about PD (Parkinson disease) and its effects on nutritional status of a person. The
demographic factors, nutritional assessment was done by Mini-Nutritional Assessment (MNA)
Scale, and GI symptoms were assessed by validated scales. Age- and gender-matched cohort
controls were randomly selected to correlate the GIT symptoms influencing nutritional status.
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The study population was divided into two groups according to the MNA score; Group I
malnourished/at risk of malnutrition (score <23.5) or Group II normal nutrition (>23.5). The two
subgroups were then compared.
For my paper, I used two articles other than ATI to collect the information. The sources I
used are other than the ATI modules. And they are latest and less than 5 years old.
Article Findings
1. How it addresses the topic: In this study, authors conducted research on the malnutrition
and how Parkinson disease effect on consuming nutrition. The study is satisfying my
research needs because I picked the same question. I am also finding out the effect of health
conditions on nutritional status.
2. Type of research conducted: in this research, a prospective observational study was
conducted, including all consecutive adults between 30 and 80 years with idiopathic
Parkinson's who attended the Outpatient Department of Neurology of our tertiary care
teaching hospital in Northern India. The study is conducted between July 1, 2016, and June
30, 2017. Nutritional status assessment was done using (1) anthropometrics – (a) weight (to
the nearest 0.1 kg using calibrated weighing scale), (b) height (to the nearest cm using
common measuring scale), (c) body mass index (BMI) – weight (kg)/height2 (cm) where
BMI of <18.5 kg/m2 was considered as undernutrition, 18.5–22.9 as normal, 23–−24.9 as
overweight, 25–29.9 as pre-obese, and >30 as obese as per the WHO classification for
Asian population,.
3. Findings of research: in the study, total Seventy-five PD patients were studied along with 35
controls. Forty PD patients were male (53.3%) and 35 (46.6%) were female, while in the
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control group, there were 18 male (51.5%) and 17 female (48.5%). The mean age of the
study group and control group was 63 + 10.5 years and 62 + 9.46 years, respectively.
According to the severity of the disease, 41.3% had mild-to-moderate disease (H and Y
stage: 0–2.5) and remaining 58.6% had advanced disease (H and Y > 3). Among the PD
patients, the symptoms of constipation, dysphagia, and sialorrhea were present in 31
patients (41.3%), 22 patients (29.3%), and 22 patients (29.3%), respectively, as compared to
1 person (2.8%) in the control group who had constipation and dysphagia each and none
had sialorrhea. On comparison of the gastrointestinal symptoms within the two MNA
groups in the PD population, constipation (P = 0.0042), dysphagia (P = 0.00081), and
sialorrhea (P = 0.041) were significantly associated with Group I (at risk of malnourishment
and malnourished patients) as compared to those with normal nutritional status (MNA >24)
4. Why this article was chosen: this article has a great study conducted and it satisfy my
question and topic needs. I like the elaboration of the study.
Evidence for Practice
1. Summary of evidence: the study was showing that more approximately half of the
population selected is a risk of malnutrition due to Parkinson disease. The patient has the
main problem with dysphagia, sialorrhea, and constipation. Some people have the
symptoms of GI upset and NV too. They cannot teat proper food or they cannot take full
advantage of the diet. But they are under the essential nutritional status.
2. How it will improve practice: Appropriate identification of the symptoms and nutritional
status will lead to the proper interventions. This may prevent/ delay the associated poor
outcome. It is also very important to screen for malnutrition at the time of Parkinson disease
diagnose and on follow-up.
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3. How this evidence will decrease a gap to practice: This will help to decrease the gap while
practicing such study because GI symptoms are directly associated with Parkinson disease
and further putting a great impact on the diet we take.
4. Any concerns or weaknesses located in the evidence: small study group is the main
drawback. We cannot depict the whole population from a small sample. The other thing is
geographical location is urban area. It is not representing the rural population. One more
thing, most of the assessment was based on questionnaire, therefore, the study has a
limitation of recall bias.
Sharing of Evidence
1. Who would you share the information with: I would like to share the information with study
groups like students, researchers and analysts. They might use the information for further
research.
2. How would you share this information: The research papers are available on the internet as
scholarly articles. I would like to provide research evidence, conducted study and survey
etc.
3. What resources would you need to accomplish this sharing of evidence: this is a
technological era. And people like to use internet for their investigation and information.
I will use technology for sharing purpose.
4. Why would it be important to share this evidence with the nursing profession: it is always a
great thing to share your research with the people who can learn from it. This could be a
great information for the medical professionals because they are directly dealing with the
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patients and taking care of them. They could use this information more efficiently and
effectively and save their clients from malnutrition.
Conclusion
GI disturbance is very common in Parkinson disease. And it effects on all the levels of
health. It is a main reason of nausea and vomiting, constipation etc. Patients cannot be
comfortable to eat when their stomach is upset. So, it leads to poor intake of the diet and not
metabolized our food properly. Therefore, medical team should pay attention to these GI
symptoms during evaluation of PD patients. If we could timely identify the problem, then we can
adopt promptly treatment to reduce the risk of associated complications like malnutrition and
hence increased morbidity.
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Reference
Ongun N. (2018). Does nutritional status affect Parkinson's disease features and quality of
life? PloS One, 13(10).
Paul BS, Singh T, Paul G, Jain D, Singh G, Kaushal S, Chhina RS. Prevalence of Malnutrition in
Parkinson's Disease and Correlation with Gastrointestinal Symptoms. Ann Indian Acad
Neurol. 2019 Oct-Dec;22(4):447-452. doi: 10.4103/aian.AIAN_349_18. Epub 2019 Oct
25. PMID: 31736567; PMCID: PMC6839331.