Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: Prevalence of malnutrition and the relation of various factors to nutritional status

Droogsma, E.; Asselt, D.Z.B. van; Schölzel-Dorenbos, C.J.M.; Steijn, J. H. M. Van; Walderveen, P. E. Van; Hooft, C

doi:10.1007/s12603-013-0032-9

Cited by 70 publications

(73 citation statements)

References 34 publications

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“…Recent studies also utilized the MNA test cross-sectionally and longitudinally in patients with dementia (1,6,9,10). The reported rate of malnutrition among communitydwelling AD patients varies between 0% and 23.2% in different populations (7,9,(11)(12)(13). However, the rate of malnutrition was higher in our study compared to these previously published studies.…”

Section: Discussioncontrasting

confidence: 81%

Malnutrition is associated with dementia severity and geriatricsyndromes in patients with Alzheimer disease

Yıldız¹,

Pekel²,

Tolgay³

et al. 2015

Turk J Med Sci

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Background/aim: Malnutrition is associated with increased morbidity and mortality in patients with Alzheimer disease (AD). In this study, we aimed to screen for malnutrition and geriatric syndromes and seek their associations in patients with AD. Materials and methods:The Mini Mental State Examination (MMSE), Mini Nutritional Assessment (MNA), Katz Activities of Daily Living (ADL), and Lawton Instrumental Activities of Daily Living (IADL) tests were applied. Mean daily oral fluid intake was assessed according to patients' and relatives' declarations.Results: Seventy-six patients with a mean age of 79 ± 7.4 years were included. Most of the patients had mild or moderate dementia. Malnutrition was associated with increased rates of hospitalization and falls, dysphagia, insomnia, agitation, delusions, hallucinations, immobility, and incontinence. A daily fluid intake of <1100 mL was associated with malnutrition risk. Multivariate linear regression analysis revealed independent correlations of lower MNA score with lower ADL score, lower daily oral fluid intake, lower MMSE score, and female sex. Conclusion:Dependency, inadequate fluid intake, advanced dementia stage, and female sex were independently associated with malnutrition. Malnutrition also seemed to be associated with sleep disturbances, psychological problems, immobility, falls, and increased hospitalization risk in these patients. Daily oral fluid intake may be a practical tool in the screening of malnutrition.

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Section: Discussioncontrasting

confidence: 81%

Malnutrition is associated with dementia severity and geriatricsyndromes in patients with Alzheimer disease

Yıldız¹,

Pekel²,

Tolgay³

et al. 2015

Turk J Med Sci

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“…Replication of these preliminary findings in community-based populations with more diversified demographical, socio-economic, ethnical and medical status, as well as with other biomarkers of AD, is warranted and clinical application is not justified. There is evidence that, among newly diagnosed AD patients, those at risk of malnutrition have more severe impairments of basic and complex daily functioning than well-nourished AD patients (62). These data indicate that assessment of nutritional status is valuable in the diagnostic work up of AD, and that aging individuals might benefit from nutritional interventions implemented prior to developing disease-related malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Nutrient patterns and brain biomarkers of Alzheimer's disease in cognitively normal individuals

Berti

Murray

Davies

et al. 2015

The Journal of nutrition, health and aging

129

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Objectives Epidemiological evidence linking diet, one of the most important modifiable lifestyle factors, and risk of Alzheimer’s disease (AD) is rapidly increasing. However, there is little or no evidence for a direct association between dietary nutrients and brain biomarkers of AD. This study identifies nutrient patterns associated with major brain AD biomarkers in a cohort of clinically and cognitively normal (NL) individuals at risk for AD. Design Cross-sectional study. Setting Manhattan (broader area). Participants Fifty-two NL individuals (age 54+12 y, 70% women, Clinical Dementia Rating=0, MMSE>27, neuropsychological test performance within norms by age and education) with complete dietary information and cross-sectional, 3D T1-weighted Magnetic Resonance Imaging (MRI; gray matter volumes, GMV, a marker of brain atrophy), 11C-Pittsburgh compound-B (PiB; a marker of fibrillar amyloid-β, Aβ) and 18F-fluorodeoxyglucose (FDG; a marker of glucose metabolism, METglc) Positron Emission Tomography (PET) scans were examined. Measurements Dietary intake of 35 nutrients associated with cognitive function and AD was assessed using the Harvard/Willet Food Frequency Questionnaire. Principal component analysis was used to generate nutrient patterns (NP) from the full nutrient panel. Statistical parametric mapping and voxel based morphometry were used to assess the associations of the identified NPs with AD biomarkers. Results None of the participants were diabetics, smokers, or met criteria for obesity. Five NPs were identified: NP1 was characterized by most B-vitamins and several minerals [VitB&Minerals]; NP2 by monounsaturated and polyunsaturated fats, including ω-3 and ω-6 PUFA, and vitamin E [VitE&PUFA]; NP3 by vitamin A, vitamin C, carotenoids and dietary fibers [Anti-oxidants&Fibers]; NP4 by vitamin B12, vitamin D and zinc [VitB12&D]; NP5 by saturated, trans-saturated fats, cholesterol and sodium [Fats]. Voxel-based analysis showed that NP4 scores [VitB12&D] were positively associated with METglc and GMV, and negatively associated with PiB retention in AD-vulnerable regions (p<0.001). In addition, both METglc and GMV were positively associated with NP2 scores [VitE&PUFA], and negatively associated with NP5 scores [Fats] (p<0.001), and METglc was positively associated with higher NP3 scores [Anti-oxidants&Fibers] (p<0.001). Adjusting for age, gender, ethnicity, education, caloric intake, BMI, alcohol consumption, family history and Apolipoprotein E (APOE) status did not attenuate these relationships. The identified ‘AD-protective’ nutrient combination was associated with higher intake of fresh fruit and vegetables, whole grains, fish and low-fat dairies, and lower intake of sweets, fried potatoes, high-fat dairies, processed meat and butter. Conclusion Specific dietary NPs are associated with brain biomarkers of AD in NL individuals, suggesting that dietary interventions may play a role in the prevention of AD by modulating AD-risk through its effects on Aβ and associated neuronal impairment.

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“…The number of community-dwelling AD patients with weight loss described in the literature varies between 20 % and 45 % [5,13,14,21,52,55]. The number of community-dwelling AD patients at risk of undernutrition according to the mini-nutritional assessment (MNA), which is a validated screening and assessment tool to identify risk of undernutrition in older people [23,49], varies from 14 % to 80 % [8,17,21,35,36,40,41,44,48] and the number of undernourished patients (according to the MNA) varies from 0 % to 9 % [8,20,40,41]. This wide variation in the number of community-dwelling AD patients with weight loss and (risk of) undernutrition could be explained as follows: the highest prevalence of weight loss and (risk of) undernutrition were reported in studies from the precholinesterase inhibitor (ChEI) era [13,52,55].…”

Section: Epidemiology Of Weight Loss and Undernutritionmentioning

confidence: 99%

“…Even though severe undernutrition might not be an issue in communitydwelling AD patients, one in seven community-dwelling elderly people with newly diagnosed AD was at risk of undernutrition in a recently published investigation [8] and other studies reported even higher rates [17,21,35,36,40,41,44,48]. Given the suggested adverse outcomes of weight loss and (risk of) undernutrition, it is important to pay attention to the nutritional status of community-dwelling AD patients.…”

Section: Epidemiology Of Weight Loss and Undernutritionmentioning

confidence: 99%

“…Therefore, these factors need to be addressed. In the study on the prevalence of undernutrition and its relation to various factors in community-dwelling elderly with newly diagnosed AD, it was shown that the degree of impairment in daily functioning is independently related to nutritional status [8]. In addition, it was shown that community-dwelling AD patients without an informal caregiver or partner had a lower average weight compared to patients with an informal caregiver or partner [7].…”

Section: Interventions Targeting the Underlying Proposed Causes And Rmentioning

confidence: 99%

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Weight loss and undernutrition in community-dwelling patients with Alzheimer’s dementia

2015

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Weight loss and undernutrition are commonly described in patients with Alzheimer's disease (AD) and have been associated with various adverse outcomes. Therefore, it is important to know what the best approach is to community-dwelling AD patients with a risk of developing a poor nutritional status; however, there is currently no evidence on which to base nutritional recommendations. Expert based recommendations are that the nutritional status should be part of the work-up of all AD patients. If weight loss of 5% or more has occurred in 3-6 months or if the mini-nutritional assessment (MNA) classifies a patient as undernourished, a nutritional intervention should be started. The intervention should be multifactorial and encompass treatment of the underlying proposed causes and risk factors of weight loss and undernutrition as well as improvement of the nutritional status by increasing energy and protein intake combined with daily physical activity.

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Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: Prevalence of malnutrition and the relation of various factors to nutritional status

Cited by 70 publications

References 34 publications

Malnutrition is associated with dementia severity and geriatricsyndromes in patients with Alzheimer disease

Malnutrition is associated with dementia severity and geriatricsyndromes in patients with Alzheimer disease

Nutrient patterns and brain biomarkers of Alzheimer's disease in cognitively normal individuals

Weight loss and undernutrition in community-dwelling patients with Alzheimer’s dementia

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