Affiliations: [a] Department of Psychiatry, The Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
| [b] Department of Epidemiology, The College of Public Health, The University of Iowa, Iowa City, IA, USA
| [c] Department of Neurology, The Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
| [d] Stead Family Department of Pediatrics, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| [e] Division of Pharmacy Practice and Sciences, The College of Pharmacy, The University of Iowa, Iowa City, IA, USA
Correspondence to: Amy C. Ogilvie, MS, Graduate Research Assistant, Department of Psychiatry, Carver College of Medicine at the University of Iowa, 200 Hawkins Drive, W249 GH, Iowa City, IA 52242, USA. E-mail: [email protected].
Note:  Statistical Analysis conducted by Amy C. Ogilvie.
Abstract: Background:Unintended weight loss and decreased body mass indexes (BMIs) are common symptoms of individuals with manifest HD. It is unknown at what point during disease progression weight loss starts to accelerate relative to a healthy individual’s weight and when recommended interventions should be initiated to have the strongest impact on patient care. Objective:The objective of this study was to identify a point in time relative to age at motor onset when the decline in weight in HD starts to accelerate relative to a non-HD population. The relationship between initiation of weight loss interventions and changes in weight loss was also explored. Methods:Participants from the fifth version of the Enroll-HD study were identified for this research. Linear mixed-effects piecewise regression models were used to estimate the point in time relative to the reported age of motor onset in which BMI started to decline in participants with HD compared to healthy non-HD controls. A post-hoc descriptive analysis was performed to look at when nutritional supplements and swallow therapy were initiated in participants with HD relative to motor onset. Results:BMI decline in the HD group began to accelerate compared to controls approximately 5.7 years after the reported age of motor onset (95% CI: 4.7–6.9). The average initiation times of swallow therapy and nutritional supplements were 7.7 years (SD = 5.5 years) and 6.7 years (SD = 6.5 years) after motor onset, respectively. Conclusion:Our findings suggest a potential point for intervention of nutrition programs or therapies used to prevent future weight loss.
Keywords: Huntington’s disease, disease progression, body-weight trajectory, weight loss