Poehlman E T, Dvorak R V
Department of Medicine, University of Vermont, Burlington 05405, USA.
J Nutr Health Aging. 1998;2(2):115-8.
Alzheimer's disease type dementia is a growing health problem and is one of the leading causes of death among elderly people. Unexplained weight loss and cachexia is a frequent clinical finding in patients with Alzheimer's disease. It has been postulated that Alzheimer's disease may by characterized by dysfunction in body weight regulation. This brief review examines energy intake, energy expenditure and body composition in Alzheimer's disease. We consider whether inappropriately high levels of energy expenditure may contribute to unexplained weight loss and decline in nutritional status. Specifically, we will consider studies that have examined body composition, daily energy expenditure and its components. The application of doubly labeled water and indirect calorimetry to problems of "wasting" has increased our knowledge regarding energy expenditure and physical activity levels in Alzheimer's patients. Although the number of studies are limited, results do not support the notion that a "hypermetabolic" state contributes to unexplained weight loss in Alzheimer's disease, even in cachectic patients. Clinical strategies aimed at developing feeding strategies to maintain adequate caloric intake and the restoration of energy balance should be a future area of investigation in Alzheimer's research.
阿尔茨海默病型痴呆是一个日益严重的健康问题，也是老年人主要死因之一。不明原因的体重减轻和恶病质是阿尔茨海默病患者常见的临床症状。据推测，阿尔茨海默病可能以体重调节功能障碍为特征。本简要综述探讨了阿尔茨海默病患者的能量摄入、能量消耗和身体组成。我们考虑过高的能量消耗水平是否可能导致不明原因的体重减轻和营养状况下降。具体而言，我们将考虑那些研究身体组成、每日能量消耗及其组成部分的研究。双标记水法和间接测热法在“消瘦”问题上的应用增加了我们对阿尔茨海默病患者能量消耗和身体活动水平的了解。尽管研究数量有限，但结果并不支持“高代谢”状态导致阿尔茨海默病患者不明原因体重减轻这一观点，即使是恶病质患者也是如此。旨在制定喂养策略以维持足够热量摄入和恢复能量平衡的临床策略应成为阿尔茨海默病研究未来的一个调查领域。
