Understanding Energy Expenditure: An Approach to Improving Activities of Daily Living in Huntington's Disease

Background/Objective: Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder characterized by motor dysfunction, cognitive impairment, and psychiatric symptoms. As the disease progresses, weight loss, cachexia, and musculoskeletal atrophy are common, reducing quality of life, decreasing their autonomy in their activities of daily living (ADLs), and increasing morbidity and mortality risk. To describe and compare energy expenditure (EE) during ADLs and resting conditions in individuals with HD and healthy controls, and to examine its associations with quality of life, cognitive status, motor function, and functional capacity. Methods: A cross-sectional observational study was conducted with 16 people with manifest HD and 10 healthy controls. Participants completed five ADLs: resting, dressing, combing hair, feeding, and walking under laboratory conditions. EE during ADLs was measured using a portable indirect calorimetry system. Results: Statistically significant between-group differences in EE were found only during feeding, with individuals with HD showing higher EE than controls (p = 0.021). In the exploratory correlation analysis, cognitive status was significantly associated with EE during dressing (p = 0.033). Conclusions: This exploratory study contributes to the limited evidence on EE during ADLs in adults with HD. The findings suggest that individuals with HD may expend more energy than healthy controls during specific daily activities, particularly feeding. However, these results should be interpreted with caution due to the small sample size and preliminary nature of the study. Larger, multicenter, and longitudinal studies are needed to confirm these findings and determine their clinical relevance.