Abstract
Objective
To determine whether being overweight or obese contributes to disease progression
and functional status in Parkinson's disease (PD).
Design
Cohort study using data from the Parkinson Progression Markers Initiative (PPMI).
Setting and Participants
A total of 399 drug-naive patients with early PD were classified into normal weight
(body mass index of 18.5–24.9, n = 139), overweight (25.0–29.9, n = 167), and obese
(30.0 or more, n = 93) groups.
Methods
The primary outcome was the development of functional dependency. Functional dependency
was defined as a Schwab and England score of less than 80% at any time point that
remained throughout follow-up. The secondary outcomes were the changes in the Movement
Disorders Society Unified Parkinson Disease Rating Scale motor score measured in the
off-medication state and the Montreal Cognitive Assessment score across visits.
Results
Over a 5-year follow-up period, the incidence of functional dependency was higher
in the obese group than in the normal weight group (P = .001). No difference was observed between the overweight and normal weight groups
(P = .429). The multivariable Cox model confirmed that obesity, but not overweight,
increased the risk of dependency (hazard ratio 2.63, 95% confidence interval 1.32–5.23,
P = .006). The increase in the Movement Disorders Society Unified Parkinson Disease
Rating Scale motor score was greater in the obesity (P < .001) and overweight (P = .004) groups than in the normal weight group. Changes in the Montreal Cognitive
Assessment score did not differ among the groups (P = .978).
Conclusions and Implications
We found that obesity is related to an increased risk of functional dependency and
rapid motor progression in patients with early PD. Although being overweight did not
increase the risk of dependency, this condition was associated with rapid motor progression.
Keywords
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Article info
Publication history
Published online: January 13, 2020
Footnotes
Parkinson's Progression Markers Initiative (PPMI), a public private partnership, is funded by the Michael J. Fox Foundation for Parkinson's Research and funding partners, including AbbVie, Avid, Biogen, Bristol-Myers Squibb, Covance, GE Healthcare, Genentech, GlaxoSmithKline, Lundbeck, Eli Lilly, Merck, Meso Scale Discovery, Pfizer, Piramal, Roche, Sanofi Genzyme, Servier, TEVA, and UCB.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
The authors declare no conflicts of interest.
Author Contributions: Dr. R Kim designed the research, acquired and analyzed the data and drafted the manuscript. Dr. JS Jun designed the research, analyzed the data, and made critical revisions to the manuscript.
Identification
Copyright
© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
