El papel de la alimentación en la sintomatología de pacientes con enfermedad de Parkinson: una revisión sistemática

Introduction

Parkinson's disease (PD) is a neurodegenerative disease that is characterized by the loss of dopaminergic neurons and a dopamine deficit. The symptomatology associated with PD is diverse. The clinical manifestations of patients include motor and non-motor symptoms. One of the non-motor symptoms is weight loss and a high risk of malnutrition. It is important to consult neurology regarding the diagnosis and follow-up of patients with PD.

Objective

To show the relationship between dietary habits and signs and symptoms in Parkinson disease.

Method

The methodology used consisted of a systematic review of narrative analysis on the relationship between food and the symptoms associated with PD. The databases consulted through the critical reading programme (critical appraisal skills programme, Spanish) were: MedLine, Web of Science, Scopus and PubMed. Among the inclusion criteria: studies in Spanish and English were accepted. The time range was from 2014 to 2019. The search terms used were: “Parkinson's Disease”, “Healthy Diet”, “Feeding Behaviour” and “Signs and Symptoms”.

Results

A total of 85 published study documents were identified, of which 8 met the inclusion criteria. Three documents were included from the literature review of grey literature and 11 selected documents were analysed.

Approximately 60% of patients with PD suffer from constipation. A high fibre diet and proper hydration are essential. Modified texture diets are the first strategic line in the management of dysphagia and will have to be considered in the treatment of PD. Vitamin D intake was found to be decreased and supplementation should be considered. Other non-motor symptoms in early stages, such as depression and hyposmia, may affect dietary choices and be responsible for the observed nutritional status decline.

Conclusions

Nutritional care should be considered as an integral part of the treatment of patients with PD, because the nutritional status of patients with PD is a relevant component of their quality of life. In addition, malnourished patients with PD suffer more pronounced motor symptoms and a more advanced status of PD.