Prevalence of malnutrition/malnutrition risk and nutrition-related risk factors among patients with Parkinson's disease: systematic review and meta-analysis

Introduction The clinical symptoms and nutritional status of patients with Parkinson's disease (PwP) are interrelated, and the clinical outcomes in malnourished patients are often poor. Only a few studies have reviewed the prevalence of malnutrition and nutrition-related risk factors in PwP. Objective To explore the prevalence of malnutrition/ malnutrition risk among PwP, and estimate nutrition-related risk factors. Methods PubMed, EMBASE, and Cochrane Library were systematically searched. Literatures published between 1 January 1995 and 1 November 2020, subjects were patients with idiopathic PD underwent Mini Nutritional Assessment (MNA) were included. Result Sixteen articles, including 1650 PwP from 13 countries/regions, were included in the meta-analysis. The prevalence of malnutrition and malnutrition risk were 8.8% (Confidence interval [CI] 95%, 5.3%-12.2%) and 35.3% (CI 95%, 29.0%-41.7%), and the prevalence of nutritional disorders was 42.3% (CI 95%, 33.7%-51%). The prevalence of malnutrition in developing countries was higher than that in the developed countries. Meta-analysis reveals there were significant differences in the course of the disease (0.88 years; 95% CI, 0.26-1.50), levodopa equivalent daily dose (LEDD; 60.77 mg/day; 95% CI, 2.7-118.8), Hoehn and Yahr (H&Y) staging (0.323; CI 95%, 0.164-0.482), and unified Parkinson's disease rating scale (UPDRS) scores (total: 13.66, CI 95%: 10.57-16.75 and part III: 5.52, CI 95%: 3.79-7.25) between normal and nutritional disorder groups. Conclusions Malnutrition/malnutrition risk prevalence in PwP are high. The duration of the disease, LEDD, H&Y staging, and UPDRS score (part III and total) may be nutrition-related risk factors in PwP.