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. 2024;14(7):1441-1450.
doi: 10.3233/JPD-240181.

Association Between Body Mass Index Changes and All-Cause Mortality in Parkinson's Disease

Seo Yeon Yoon  1 , Ja Young Choi  2 , Ga Eun Nam  3 , Jin-Hyung Jung  4 , Kyungdo Han  5 , Sung Hoon Kang  6 , Chi Kyung Kim  6 , Yong Wook Kim  1 , Seong-Beom Koh  6
Affiliations

Association Between Body Mass Index Changes and All-Cause Mortality in Parkinson's Disease

Seo Yeon Yoon et al. J Parkinsons Dis. 2024.

Abstract

Background: Whether body weight changes are associated with Parkinson's disease (PD) mortality remains uncertain.

Objective: To investigate the association between changes in body mass index (BMI) and all-cause mortality in patients with PD.

Methods: This nationwide cohort study enrolled 20,703 individuals with new-onset PD (ICD-10 code: G20 and a rare intractable disease registration code: V124) who underwent health screening program by the Korean National Health Insurance Service within two years from pre- and post-PD diagnosis. We identified nine BMI change groups based on three BMI status: underweight (BMI < 18.5 kg/m2), normal or overweight (18.5 kg/m2≤BMI < 25 kg/m2), and obese (BMI≥25 kg/m2).

Results: Of 20,703 individuals, 3,789 (18.0%) died during the follow-up period. Excessive weight loss to underweight in the obese group (hazard ratio [HR] = 3.36, 95% CI:1.60-7.08), weight loss in the normal to overweight group (HR = 2.04, 95% CI:1.75-2.39), sustained underweight status (HR = 2.05, 95% CI:1.67-2.52), and weight gain from underweight to normal or overweight (HR = 1.52, 95% CI:1.15-2.02) were associated with increased mortality. Sustained obese status (HR = 0.80, 95% CI:0.74-0.87) and weight gain in the normal to overweight group (HR = 0.82, 95% CI:0.71-0.95) were associated with reduced mortality.

Conclusions: We found that BMI change at diagnosis was associated with mortality in patients with PD. Specifically, being underweight either before or after diagnosis as well as experiencing weight loss, were associated with increased mortality. These findings provide valuable insights for weight management planning in PD, highlighting the importance of individualized approach that consider pre-diagnosis BMI.

Keywords: Body mass index; Parkinson’s disease; cohort study; mortality; weight change.

Plain language summary

Whether body weight changes are associated with Parkinson’s disease (PD) mortality remains uncertain. This study looked at how changes in body weight affect the chances of survival in people who have recently been diagnosed with PD. We followed 20,703 individuals who were newly diagnosed with this condition and checked their weight changes before and after their diagnosis. We found that people with PD who lost a lot of weight to become underweight had a higher risk of dying during our study. Similarly, those who were already underweight and remained so also had a higher mortality risk. On the other hand, people who maintained a weight or gained a small amount of weight after their diagnosis had the lowest risk of dying. Our research found that weight changes at diagnosis were associated with mortality in PD, with underweight or weight loss being linked to increased risk of death. Each person’s situation is different, so weight management should be tailored to each individual, considering their weight before they were diagnosed with PD.

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Conflict of interest statement

The authors have no conflict of interest to report.

Figures

Fig. 1
Fig. 1
Kaplan–Meier Curves of All-Cause Mortality Stratified by Body Mass Index Change Status in Individuals with Parkinson’s Disease.
Fig. 2
Fig. 2
Restricted Cubic Spline Plots of Association between Body Mass Index Difference and All-Cause Mortality in Individuals with Parkinson’s Disease.
See this image and copyright information in PMC

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