Gil Gregorio P, Ramirez Diaz S P, Ribera Casado J M
Hospital Clínico San Carlos, Geriatric Department, Martín Lagos S/N, 28040 Madrid, Spain.
J Nutr Health Aging. 2003;7(5):304-8.
To know nutritional status of a group of institutionalized patients with moderate Alzheimer's Disease (AD), and to ascertain the effects of an intervention with nutritional supplements on morbidity and mortality after one year follow-up.
99 patients (mean age: 86.5 years), 80 women, with a diagnosis of AD according with NINCDS/ADRDA criteria, were recruited from 8 nursing-homes. 25 were included in an intervention group and received a nutritional supplements along 12 months. Evolution was evaluated according to the Functional Assessment Staging Test (FAST). Patients with FAST levels 5-6 were included. General clinical variables as well as variables reflecting cognitive state and nutritional status: anthropometric, biochemical data and Mini Nutritional Assessment (MNA) were analysed. Statistical analysis was carry out with the SPSS 10.0 package.
Mean time since diagnosis was 49 months, with a 20.2 months duration of institutionalization. Mean value of MNA was 20.1 3.5. 16.5% of patients had a BMI equal o lower than 21. After one year the intervention group showed higher levels of albumin (P=05), pre-albumin (P=05), iron (P=01), zinc (P=05), and beta-carotene (P=05) than the control group. The same response in BMI (P=05), MNA (P=05), and triceps skinfold (P=01). Mortality was lower (16% vs. 22.7%), without statistical significance, in the intervention group, as it was the number of infectious events (47% vs. 66% P=05), and the days in bed (7.5 2.1 vs. 17.3 5.6 P=05).
Nutritional supplements applied to a group of patients with AD living in nursing-homes can reduce morbidity and mortality after one year follow-up.
了解一组中度阿尔茨海默病(AD)机构化患者的营养状况,并确定营养补充剂干预对一年随访后的发病率和死亡率的影响。
从8家养老院招募了99例患者(平均年龄:86.5岁),其中80名女性,符合NINCDS/ADRDA标准诊断为AD。25例被纳入干预组,接受了为期12个月的营养补充剂。根据功能评估分期测试(FAST)评估病情进展。纳入FAST水平为5 - 6级的患者。分析了一般临床变量以及反映认知状态和营养状况的变量:人体测量学、生化数据和微型营养评定法(MNA)。使用SPSS 10.0软件包进行统计分析。
自诊断以来的平均时间为49个月,机构化时间为20.2个月。MNA的平均值为20.1±3.5。16.5%的患者BMI等于或低于21。一年后,干预组的白蛋白(P = 0.05)、前白蛋白(P = 0.05)、铁(P = 0.01)、锌(P = 0.05)和β - 胡萝卜素(P = 0.05)水平高于对照组。BMI(P = 0.05)、MNA(P = 0.05)和肱三头肌皮褶厚度(P = 0.01)也有相同的变化。干预组的死亡率较低(16%对22.7%),无统计学意义,感染事件数量(47%对66%,P = 0.05)以及卧床天数(7.5±2.1对17.3±5.6,P = 0.05)也是如此。
应用于一组居住在养老院的AD患者的营养补充剂可在一年随访后降低发病率和死亡率。