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Abstract

A number of phenotypes are being identified in the neurodegenerative Parkinsonâ�?�?s disease, mostly in reference to the nonmotor symptoms. One purpose of identifying phenotypes is to manage disease process more effectively. PD patients have variable impairment of olfaction; high proportions develop body-weight change (gain or loss) as the disease advances. PD patients have a lower body weight as compared to non-PD controls. Weight loss in PD is not a benign phenomenon. Lower initial body weight and weight loss during the course of the disease predispose to the risk of dyskinesia; there being a relationship between body weight and levodopa dose per kilogram for dyskinesia. Additionally weight loss increases the risk of undernutrition, frailty, poor quality of life and mortality. Patients at the risk of weight loss may be identified by their severe olfactory loss (anosmia) at an early stage, since anosmia, as compared to hyposmia, seems to represent more severe neurodegenerative process predisposing to weight loss and dyskinesia describing the â�?�?olfaction-weight-dyskinesiaâ�? phenotype in Parkinsonâ�?�?s disease. Weight loss is not due to higher energy expenditure or lower energy intake. The basis of severe neurodegenerative process and weight loss might be a longer pre-clinical phase in this phenotype. PD patients should be monitored for weight loss and the dose of levodopa adjusted accordingly as the disease advances. Measures should be taken to prevent weight loss in such patients to prevent the low body-weight related non-motor and motor adverse effects. This may result into better quality of life.

Biography

Email: jagdish.sharma@ulh.nhs.uk