Cicconetti P, Fionda A, Bauco C, Migliori M, Marigliano V
Cattedra di Gerontologia e Geriatria, Università La Sapienza, Roma.
Recenti Prog Med. 2000 Mar;91(3):135-40.
Weight loss is a very common problem for patients with Alzheimer's Disease (AD), whether they live at home or in long-term care facilities. At any rate it depends on an imbalance between energy expenditure and intake. Though in the initial phases of the illness, the weight loss might be caused by socio-environmental and psychological factors and reduced autonomy, in the following stages it depends on Adversive Feeding Behaviours (AFBs). The AFBs invariably lead to protein, fat and sugar deficits as well as a vitamin deficit which presents a positive correlation with the cognitive performance level and negatively affects the course of the disease. Thus it is important to identify AFBs (Blandford Scale) as soon as possible, especially when they can be treated. Furthermore it is very important to recognise weight loss immediately and identify a possible malnutrition state, using investigative methods which allow for follow-up monitoring (Mini Nutritional Assessment). Pharmacological therapy of cognitive deficit and AFBs together with possible contemporary conditions (depression) and intervention on the nutrition, will be useful to avoid a deficiency state and the consequent negative repercussion on the disease.
体重减轻是阿尔茨海默病(AD)患者非常常见的问题,无论他们是居家生活还是住在长期护理机构。无论如何,这取决于能量消耗和摄入之间的不平衡。在疾病的初始阶段,体重减轻可能是由社会环境和心理因素以及自主性降低引起的,但在随后的阶段,这取决于不良进食行为(AFB)。不良进食行为总是会导致蛋白质、脂肪和糖缺乏以及维生素缺乏,而维生素缺乏与认知表现水平呈正相关,并对疾病进程产生负面影响。因此,尽早识别不良进食行为(使用布兰德福德量表)非常重要,尤其是在它们可以得到治疗的时候。此外,立即识别体重减轻并使用能够进行后续监测的调查方法(微型营养评定法)确定可能的营养不良状态也非常重要。认知缺陷和不良进食行为的药物治疗以及可能同时存在的状况(如抑郁症),再加上营养干预,将有助于避免营养缺乏状态以及随之而来的对疾病的负面影响。