Search

Limited research exists regarding the diet quality and nutritional concerns of people with Parkinson's disease (PwPD) and their informal caregivers. The study's purpose was to assess diet quality via the Healthy Eating Index-2015 (HEI-2015) and self-reported nutrition concerns via semi-structured, dyadic interviews of 20 PwPD (69.7 ± 9.2 yrs) and their caregivers (66.7 ± 13.0 yrs). HEI-2015 scores were 58.3 ± 12.4 and 58.1 ± 10.6 for PwPD and caregivers, respectively. Reported dietary concerns related to PD included: change in appetite or amount eaten, gastrointestinal issues, food-medication management, chewing/swallowing issues, and change in taste/smell. The poor diet quality and nutrition concerns identified suggest nutrition professionals and caregivers are critical on the healthcare team to promote optimal health among PwPD. Future research should address overall and specific aspects of diet quality, and nutritional concerns identified by dyads in this study, such as gastrointestinal issues and food-medication management.

For individuals with Parkinson’s disease (PD), dietary habits affect disease symptoms, progression, and overall health. Protein consumption is of great interest because of the direct and indirect effects of specific amino acids (AAs) on disease progression and interference with levodopa medication. Proteins comprise 20 distinct AAs with varying effects on overall health, disease progression, and medication interference. Therefore, it is important to consider both the potential beneficial and detrimental effects of each AA when considering supplementation for an individual with PD. Such consideration is of particular importance because PD pathophysiology, altered dietary patterns associated with PD, and competitive absorption with levodopa have been shown to result in characteristically altered AA profiles (eg, some AAs are stored in excess while others are deficient). To address this problem, considerations for the development of a precision nutritional supplement that targets AAs specific to the needs of people with PD are discussed. The objective of this review is to provide a theoretical framework for such a supplement, detailing the current state of knowledge relating relevant evidence to such a supplement, and highlighting areas of future research. Specifically, the general need for such a supplement is discussed before a systematic examination is provided of the potential benefits and risks of dietary supplementation of each AA in people with PD. As a part of this discussion, evidence-based recommendations are provided regarding the inclusion or exclusion of each AA for such a supplement for people with PD, and areas are highlighted where additional research is needed.

This study examined the relationship of physical activity (PA) and dietary quality to android fat composition and distribution using a national representative adult sample and determined sex-based differences in these relationships. It is a cross-sectional (n = 10,014) analysis of the 2011–2018 National Health and Nutrition Examination Survey and the US department of Agriculture’s Food Patterns Equivalents datasets. Variables utilized for this analysis include PA, 24-h dietary recalls, android percent fat, and android-gynoid (A/G) ratio measured by dual-energy X-ray absorptiometry. Multiple linear regression was performed to examine the relationship between PA and/or dietary quality and android percent fat and A/G ratio adjusted for confounding factors. The study results revealed that PA and/or dietary quality were inversely related to android percent fat and A/G ratio (p < 0.05), but the sex effect was only seen between PA and A/G ratio (p = 0.003). Participants who met PA recommendations and had higher dietary quality had 2.12% lower android fat than those who did not meet PA recommendations and had lower dietary quality (p < 0.001). Both PA and dietary quality are associated with android fat reduction regardless of sex. Given the direct connection between android fat and cardiovascular and metabolic diseases, it is important to increase both PA and dietary quality.

The current study examined teaching modalities used by college students participating in an intergenerational, service-learning program that helps older adults learn technology and described reasons for older adults' continued participation in this program. Qualitative data analysis was completed using student-maintained observation logs from approximately 200 older participants. Several different teaching modalities used by student mentors were identified, including observing and listening, writing down information or creating visual aids, explaining the significance and simplifying materials, using repetition/review, and using hands-on learning. Multiple reasons for older adults' continued participation were identified, including continued progress on one topic or device; multiple topics for advanced use; learning multiple modalities to get connected; and continued learning through take-a-ways, practice, and homework. Service-learning programs can help educate health and human service professionals on best practices for working with older adults. [ Journal of Gerontological Nursing, 46 (1), 14–20.]

Background and aims This mixed‐methods study examined participants' acceptance and perception of using digital health for managing nutrition and participants' digital competence. The results will be formative for making digital nutrition education more effective and acceptable for people with Parkinson's disease (PwPD) and their informal caregivers. Methods Qualitative data were collected through in‐person semi‐structured, dyadic interviews, and questionnaires from 20 dyads (20 PwPD and their caregivers) in the Northeastern United States and analyzed throughout the 2018 to 2019 academic year. Interview transcripts were deductively coded using the framework analysis method. Phrases related to acceptance of digital health were sub‐coded into accept, neutral, or reject and those related to perceptions of digital health were sub‐coded into perceived usefulness, perceived ease of use, and awareness of digital health. Quantitative data were analyzed using independent samples t tests and Fisher's exact tests. Qualitative codes were transformed into variables and compared to digital competence scores to integrate the data. An average acceptance rate for digital health was calculated through examining the mean percent of phrases coded as accept from interview transcripts. Results Twenty‐five of 40 (62.5%) participants used the internet for at least 5 health‐related purposes and the average acceptance rate was 54.4%. Dyads rejected digital health devices if they did not see the added benefit. The majority of participants reported digital health to be useful, but hard to use, and about half felt they needed education about existing digital health platforms. There was no difference in digital competence scores between PwPD and their caregivers (28.6 ± 12.6). Conclusion Findings suggest that dyads accept and use technology but not to its full potential as technology can be perceived as hard to use. This finding, combined with digital competence scores, revealed that education is warranted prior to providing a digital nutrition intervention.

OBJECTIVES: To compare the nutrition behaviors of people with Parkinson's disease (PwPD) before and during the COVID-19 pandemic. METHODS: A 34-item open- and closed-ended online questionnaire that explores the nutrition behaviors before and during COVID-19 was distributed through PD community and support groups nationwide between September 17-December 28, 2020. To check for differences in variables before and during COVID-19, paired-sample t-tests were used and the level of statistical significance was P

Ageism is a societal concern that greatly affects the social, emotional, physical, and mental health of older adults. One way to decrease ageist attitudes and improve the treatment of older adults is to address and improve age stereotypes among young adults. Using data from students participating in an intergenerational digital-learning program, the present study investigated change in students’ stereotypes of older adults and aging. We examined change from pre- and post-scores in student attitudes toward older adults and the type of adjectives used to describe older adults. We also analyzed responses to open-ended questions about changes in perception of older adults and aging and interest in working with older adults. Findings showed that: (1) Students’ attitudes improved following participation in the program; (2) students used fewer negative words to describe older adults following participation; (3) answers to open-ended questions demonstrated that many students improved their perceptions of older adults; and (4) many students showed increased interest in working with older adults in their future careers. Programs that reduce age stereotypes should be promoted in order to reduce young people’s harmful ageist stereotypes, ensure respectful treatment of older adults in all workplace and social situations, and increase interest in aging-related fields.

OBJECTIVES: To describe the diet quality, swallow function, and disease burden of people with Parkinson's disease (PwPD) and explore the relationship between diet quality, swallow function, and health related quality of life (HRQOL). METHODS: A convenience sample of twenty PwPD participated in this study. They completed various measures including: height and weight, two 24-h recalls, a time swallow test and a self-reported HRQOL questionnaire. Body mass index (BMI, kg/m(2)) were calculated from height and weight. Healthy Eating Index (HEI)-2015, a mean to assess dietary quality, was calculated from two 24-h dietary recalls. Total and component HEI-2015 scores were examined and interpreted using the graded approach (grades A-F). Radar graphs were constructed to provide visual representation of overall HEI-sores and component scores. A time swallow test assessed swallow function. The 39-item Parkinson's Disease Questionnaire (PDQ-39) assessed PD-specific HRQOL across 8 dimensions; the higher the score the lower the HRQOL. Descriptives were reported as mean ± standard deviation, frequencies, and percentages. Correlations were used to examine associations between outcome variables. RESULTS: The majority of PwPD were male (65%). The mean age was 69.7 ± 9.2 years and average time since diagnosis was 7.6 ± 5.4 years. The average BMI score was 27.1 ± 5.4 kg/m(2). Mean HEI scores were 58.3 ± 12.4, translating to an F, consistent with average HEI scores for Americans. The majority (75%) had a letter grade of F or D. Mean timed swallow speed was 14.4 ± 8.4 total mL/second. However, 8 (40%) had time swallow speeds of

Digital health technologies can enhance quality of care for people with Parkinson’s disease (PwPD) and their informal caregivers (ICG), but research in this area is lacking. Developing digital health nutrition services incorporating end-user preferences is essential. This cross-sectional, mixed-method study assessed 20 PwPD and their ICG. Participants reported sources they first search for when seeking health information, the amount of effort it takes to find the information, their confidence level in finding reliable health information, and their level of trust of information obtained. Semi-structured dyadic interviews obtained information about technology, digital health, and nutrition. Transcripts were double coded by two researchers to identify nutrition service features and a >80% agreement was achieved. The mean age was 68.1±11.2 years and 65% of PwPD were male, while 80% of ICG were female. Most PwPD and ICG (82.5%) went to the internet the last time they looked up health information, and about 1/3 reported it took a lot of effort to get this information. Nearly half were concerned about the quality of the information, and approximately 70% had issues trusting health information from government agencies or diet programs. Six themes around key features for a digital nutrition intervention emerged: tailored and specific, inclusion of caregivers, promote self-efficacy, from a nutrition expert, contain a social element, and include a follow-up session. The results suggest that digital health interventions will need to be tailored to meet the needs of PwPD and their ICG.

OBJECTIVES: To describe and compare the diet quality and social engagement of people with Parkinson's disease (PwPD) and their informal caregivers (ICG). To explore relationships in diet quality and social engagement activities. METHODS: Forty participants (20PwPD, 20ICG) were assessed. They rated their participation in seven social activities (visiting friends, social groups, social events, group exercise, educational courses, paid and volunteer work) on a scale of 0–3 (never, rarely, sometimes, often). Diet quality was assessed using Healthy Eating Index (HEI) 2015 scores (ranged from 0–100). Descriptive statistics were reported. Pearson Chi-Square analysis compared social engagement activities between PwPD and ICG. Spearman correlations explored the association between diet quality and social engagement variables. RESULTS: Mean age of participants was 68.05 ± 11.2 yr, and 57.5% were female. Mean HEI-2015 score was 58.2 ± 11.4, with no difference in scores between ICG and PwPD. Half of participants (PwPD = 9, ICG = 11) reported participating in volunteer work at least once a month, and 72.5% (PwPD = 14, ICG = 15) attended social groups at least once a month. Only 30% (PwPD = 6, ICG = 6) reported taking education courses at least monthly. Eighty % of PwPD and 35% of ICG attended group exercise classes at least once a week. PwPD were more likely to participate in group exercise programs than ICG (P = 0.03). There was no association between diet quality and social engagement variables. There was a positive association between being involved in social groups and volunteering (r = 0.3, P = 0.03), taking courses (r = 0.4, P = 0.02), and visiting friends (r = 0.4, P = 0.01). A positive association was found between visiting friends and paid community work (r = 0.3, P = 0.04) and between volunteer work and taking educational courses (r = 0.5, P = 0.002). CONCLUSIONS: PwPD and ICG have low diet quality, but are engaged in a variety of social activities. Although no association between diet quality and social engagement, future research should explore if relationships exist in a larger, more diverse sample to understand how involvement in these activities can impact diet quality and quality of life. FUNDING SOURCES: There was no external funding for this study.

Technology adoption among adults 65 and older is occurring at a slower rate compared to the overall population. Research has shown that programs can help older adults learn and embrace technology. However, little information exists about what forms of technology older adults are interested in using and what strategies are used to help older adults increase technology use. This study examines qualitative data from an intergenerational service-learning program in which students in higher education teach older adults about technology. Data was analyzed from in-depth observation logs maintained by students after each educational session. Areas of technology that older adults were interested in learning included: basic functions of devices, password management, email and text messaging, organizing files and photos, using social media, and playing music. Strategies used by students to teach included: the show and tell method, note taking, use of repetition, hands-on learning, and the teach-back method. Thirty older adults who repeatedly came back to the program progressed in their building of digital competency at their own pace on one device/topic or by learning about multiple topics, including multimedia messaging and email. Findings revealed that older adults are interested in learning technology basics, communicating, and getting organized and that mastering these topics can allow for advancement in technology use in the areas of leisure, social media, finance, and health. This study provides valuable information for organizations that help older adults learn technology and for entities that design technology or want to increase technology adoption for older adults.

Parkinson’s disease, a neurodegenerative disease, impacts physical function, swallowing, and nutritional risk, but research has not examined how these health markers change longitudinally in one study. This study was an observational, longitudinal study with assessments conducted every 6 months over 4 years. The assessments included: the short physical performance battery (SPPB) (scores 75)), and weight in pounds. A one-way repeated measures ANOVA compared outcomes variables at baseline, years 2 and 4. Partial eta square are reported for effect size. Eight participants, baseline mean age 67.1±4.0 years and time since diagnosis=8.1±7.5 years, were assessed. At baseline, 3 participants exhibited possible mobility issues (SPPB=9.9±1.8), 2 participants exhibited a possible swallow issue (swallow speed=15.7±9.8mL/s), and 7 were at possible or at nutrition risk (64.0±13.8). At year 4, 5 participants exhibited possible mobility issues (SPPB=8.1±3.2, (ηp2=0.5), 4 participants exhibited a possible swallow issue (swallow speed=13.4±10.4 ml/s, ηp2=0.3), and there was a decline in perceived swallow function (77.3±12.4 vs. 74.8±16.2, ηp2=0.5). Six participants were at possible or at nutrition risk. Participants experienced weight declines from baseline to year 4 (178.5±31.4 vs.168.8±24.9, ηp2=0.5). The demonstrated decline in physical and swallow functioning, presence of nutrition risk, and experienced weight loss suggests that interdisciplinary intervention strategies may need to be designed and tested in this population.

Dietary recommendations for managing Parkinson’s disease (PD) can be confusing for people with PD (PwPD) and their informal caregivers (ICGs) who often have the responsibility to buy and prepare foods. PwPD (63-78 years of age) and their ICGs (39-75 years of age) completed two 24-hour dietary recalls and semi-structured, dyadic interviews which were conducted to gather information about dyads’ (n=9) nutrition concerns. Calorie, macro- and micro-nutrient intake were averaged over two days and compared to the National Academy of Sciences’ dietary reference intakes. Independent t-tests and the Mann-Whitney U tests compared PwPD and ICG. Interviews were audio-recorded, transcribed verbatim, and analyzed for preliminary themes. Mean calorie intake was 1766.6±658.5 kcal/d; the majority of calories were from carbohydrates. Calorie and nutrient intake between PwPD and ICG did not differ. All participants were below recommendations for fiber (17.2±7.9g/d) and potassium (2213.3±890.0mg/d) and exceeded recommendations for sodium (2741.2±1396.9mg/d) and added-sugars (59.5 ±38.3g/d). More than half of participants (55.6%) agreed an eating plan to manage PD symptoms is important and that a nutrition consultation would be helpful. Emerging themes from qualitative interviews include: nutrition concerns related to PD symptoms, managing other conditions and PD, perceptions regarding diet quality, impact of diet on PD symptoms, and complementary medicine. In conclusion, there were no differences in dietary intake between PwPD and ICG, and participants presented with lack of adherence to recommended dietary reference intakes. Sub-optimal dietary intake and self-reported nutrition concerns strongly suggest including both nutrition professionals and ICGs when providing care for PwPD.

OBJECTIVES: Digital health services are used in Parkinson's disease (PD) management across many health disciplines, but not for nutrition management. The purpose of this study is to: 1) describe nutritional risk and digital competence of people with PD (PwPD) and their informal caregivers (ICG); 2) identify facilitators and barriers for using digital health to manage nutrition; 3) identify key features to include in a digital health nutrition service for PD. METHODS: We assessed 9 PwPD and their 9 ICG. Body mass index (BMI; kg/m(2)) and waist circumference were measured. Dietary Screening Tool (DST) assessed nutrition risk. Digital competence was assessed via questions adopted from the EU Wide Indicators of Digital Competence. Audio recordings from semi-structured dyadic interviews of PwPD and their ICG relating to nutrition, technology and digital health use were transcribed verbatim and coded. A > 80% agreement was achieved for each coded aim. RESULTS: 77.8% of PwPD were male, with mean age of 70.1 ± 5.1y and disease duration of 9.0 ± 5.3y. 77.8% of PwPD and 66.7% of ICG were classified overweight/obese with central obesity; there was no difference in BMI or waist circumference scores between PwPD and ICG. All participants were at possible risk or at nutrition risk (PwPD = 55.7 ± 10, ICG = 61.7 ± 6.6). 88.9% of participants owned a smartphone and 77.8% owned a tablet. All households had a computer, 4 participants had a smart watch and 2 households owned an Amazon Alexa. There was no difference in digital competence scores between PwPD (28.3 ± 11.7) and ICG (26.8 ± 14). Facilitators to using digital health nutrition services included: the convenience technology offers; knowledge acquisition; open mindedness to try new services. Barriers included: lack of access and knowledge about nutrition for PD and/or digital health products; disinterest in technology and/or nutrition; skepticism of information validity. Factors to consider when developing a digital health nutrition service include: provide specific, tailored information; delivery from a nutrition expert; involve ICG; contain a social element. CONCLUSIONS: Findings indicate PwPD and their ICG are at nutrition risk. Digital competence scores indicate comfort with some aspects of technology but PwPD and ICG will need technical support to successfully use digital health. FUNDING SOURCES: There is no external funding for this project.

OBJECTIVES: Cardiovascular disease (CVD) risk factors include obesity, hypertension (HTN), diabetes (DM), dyslipidemia, and hyperhomocysteinemia. They are associated with accelerated cognitive decline in persons with Parkinson's disease (PwPD). Levodopa is the primary medication to manage PD but can increase homocysteine. However, PwPD taking levodopa have a lower prevalence of DM and HTN than PwPD not taking levodopa. Deep brain stimulation (DBS) is a newer PD treatment. DBS may lower levodopa dose, reducing homocysteine, but PwPD with DBS can experience weight gain. This case study will compare CVD risk factors of PwPD treated with levodopa alone versus DBS with levodopa. METHODS: Four male participants with PD (2 taking levodopa (LD1, LD2) and 2 with DBS (DBS1, DBS2) were assessed for CVD risk at ≥7 evaluations within 3y. CVD risk factors assessed: 1) body mass index (BMI) ≥25 kg/m(2); 2) diastolic blood pressure (DBP) > 80 mmHg; 3) high density lipoprotein cholesterol (HDL-C) 100 mg/dL; 5) total cholesterol to HDL-C (TC/HDL-C) ratio > 4; 6) the Dietary Screening Tool (DST); 7) Framingham's CVD 10y risk score. At baseline LD1 (62 y) was on medication for PD, HTN and dyslipidemia and had a myocardial infarction. He was following a heart healthy diet and overtime reported eating smaller portions. At baseline LD2 (70 y) was on medication for PD and to lower LDL-C. LD2 experienced decreased appetite and food intake. At baseline, DBS1 (62 y) was on medication for PD, HTN and dyslipidemia. He eats a balanced diet but is at nutritional risk. DBS2 (68 y) was taking PD, HTN medication. He self-reported swallowing and chewing issues. RESULTS: DBS1/2 TC/HDL-C ratios categorized them at risk at all time points, while LD1/2 ratios were ideal. DBS1/2 experienced high LDL-C. HDL-C values were at risk level for DBS1/2, while LD1/2 were not. All were overweight to obese, but DBS1/2 consistently had high BMI scores. DBS1/2 DST scores were at nutritional risk, while LD1/2 DST scores were at possible risk or no risk. LD1/2 had elevated DBP, while DBS1/2 had normal values. CONCLUSIONS: While all PWPD exhibit CVD risk factors, DBS treated patients may be more likely to have a greater number of risk factors after treatment. Further studies should look into risk factors before and after treatment of DBS. FUNDING SOURCES: University of Rhode Island's Enhancement of Graduate Research Award and SPARK Award.

Background Parkinson's disease (PD) and acquired brain injury (ABI) share common symptoms. People with PD and ABI risk nutritional decline at diagnosis, but little is known about their long-term health a year or more after diagnosis. Objective This cross-sectional study describes cognitive and dietary characteristics of people living with PD or ABI 12 months or more post diagnosis to identify cardio-metabolic risk factors. Methods Twelve community-dwelling participants (8 PD, 4 ABI) received interdisciplinary evaluations. Cognitive-linguistic status was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Nutritional and cardio-metabolic statuses were measured using the dietary screening tool (DST), anthropometrics, biochemical, and clinical measures. Descriptive statistics, independent t -tests and correlations were used to analyze the data. Results Mean BMI ( n = 12) was 26.8 ± 3.0 kg/m 2 and the majority of participants were overweight. Participants with PD had significantly higher total RBANS scores than participants with ABI (87.1 ± 14.6 vs. 66.0 ± 12.6, p = 0.034, d = 2.455). DST scores indicated 58% ( N = 7) at possible nutrition risk and 25% ( N = 3) were at nutrition risk. A positive correlation was found between general activity level and DST scores ( r = 0.697, p = 0.012). Multiple risk factors for development of cardiovascular disease (CVD) were present in all participants. Conclusion These findings confirmed the presence of cognitive and dietary deficits in our participant group and support the need for an interdisciplinary team approach to improve health and prevent the development of symptoms for these populations a year or more after diagnosis.