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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.