Relationship between eating problems and the risk of dementia: A retrospective study

Abstract

BackgroundOlder adults and individuals with decreased cognition often experience appetite changes and weight loss. As weight loss can result in cognitive decline, change in appetite may be an important contributor to the onset of dementia. However, there is a lack of relevant studies on this topic. This study aimed to determine the relationship between appetite changes, weight loss, and dementia onset.MethodsA total of 135 patients with normal cognitive function, subjective cognitive impairment, and mild cognitive impairment who were assessed using the Neuropsychiatric Inventory 12 item version (NPI‐12) and followed up for at least 1 month were enrolled in the study. All patients underwent a Mini‐Mental State Examination (MMSE). Eating problems were assessed using the NPI Eating Problems Score. Appetite and weight loss were assessed at the first visit by caregivers. Kaplan–Meier survival analyses with a log‐rank test were used to compare the time to the onset of dementia between the presence or absence of the NPI eating problems, appetite loss, weight loss, or NPI depression scores. Cox proportional hazards regression models using the forced entry method were employed to estimate the hazard ratio (HR) for dementia.ResultsWeight loss was significantly related to dementia onset (P = 0.027) in the Kaplan–Meier survival analyses, while eating problems, appetite loss, and depression showed no significant association (P = 0.519, P = 0.326, and P = 0.317, respectively). In the Cox proportional hazards regression models, the MMSE score was found to be a significant factor (P = 0.021, HR = 0.871); moreover, weight loss tended to increase the risk of dementia onset (P = 0.057, HR = 1.694).ConclusionsWeight loss experienced by older adults could contribute to an increased risk of developing dementia.

Comment on ‘Relationship between eating problems and the risk of dementia: a retrospective study’

“…Dear Editor, We read with great interest the retrospective study presented by Sun et al 1 which revealed that the elderly who experience weight loss can increase the risk of developing dementia. The outcome may be reasonable from physiological, medical, and psycho-social perspectives.…”

“…4 The possible mechanisms of active caloric restriction benefiting cognition are explained by decreased peripheral insulin concentration, which involves glutamate and γ-aminobutyric acid (GABA)-mediated synaptic plasticity, inducing N-methyl-D-aspartic acid (NMDA) receptor phosphorylation, increasing channel activities of NMDA receptors, and promoting gene expressions to enhance cognition. 1,5 Another Figure 1 The current trend in the publication of research on the relationship between caloric restriction and cognition. potential pathway is neurotrophic factors (such as brain-derived neurotrophic factor), which could help adaptive cellular stress response pathways and protect mature neurons from degeneration.…”

“…potential pathway is neurotrophic factors (such as brain-derived neurotrophic factor), which could help adaptive cellular stress response pathways and protect mature neurons from degeneration. 1,5 Moreover, decreased inflammatory factors such as tumour necrosis factor (TNF-α) and C-reactive protein are negatively correlated with cognitive function, of which lower TNF-α levels may also contribute to cognition by promoting insulin resistance. 5 The bibliometrics analysis showed there were a total of 1166 records in Web of Science by using the search strategy (Dietary restriction OR Caloric restriction) AND (Cognition OR Cognitive Function).…”