Olfactory function, eating ability, and visceral obesity associated with MMSE three years after Parkinson's disease diagnosis

This study examines whether risk factors for poor nutrition are associated with global cognitive function three years after confirmed Parkinson's disease (PD) diagnosis. The follow-up investigations for this prospective community-based study were conducted three years after PD diagnosis. The study participants lived in Vasterbotten County, a region in northern Sweden with 142,000 inhabitants. This study population consisted of 118 PD outpatients from the study of Newly Diagnosed PD in UmeAyen (NYPUM). Global cognition was assessed with the Mini Mental State Examination (MMSE) at baseline and at follow-up. Anthropometry, nutrition (Mini Nutritional Assessment, MNA, 3-day food registration, 3-FDR), olfactory function (Brief Smell Identification Test, B-SIT), and swallowing, cutting food, and salivation (single questions from the Unified Parkinson's Disease Rating Scale, UPDRS) were used as markers for nutritional status. The MMSE score decreased over three years (-1.06 +/- 3.38, p=0.001). Olfactory function at baseline was associated to MMSE at three years (B=0.365, p=0.004). Changes in waist/hip ratio (B=113.29, p=0.017), swallowing (B=1.18, P=0.033), and cutting food (B=-1.80, p=0.000) were associated with MMSE at follow-up. This study indicates that olfactory function, cutting food, swallowing, and visceral obesity are associated with MMSE three years after PD diagnosis.