Brocker P, Benhamidat T, Benoit M, Staccini P, Bertogliati C, Guérin O, Lechowski L, Robert P H
Centre mémoire du CHU de Nice, France.
Rev Med Interne. 2003 Oct;24 Suppl 3:314s-318s. doi: 10.1016/s0248-8663(03)80689-6.
Weight loss is common in elderly people with dementia, particularly those with Alzheimer' disease (AD), and feeding difficulties are major issues in their care in the later stages of the disease. In this study (REAL FR for Réseau sur la maladie d'Alzheimer Français) we prospectively used the Mini Nutritional Assessment (MNA) to examine the nutritional status of 479 subjects. Three groups of patients were studied: group 1 = 22 patients with undernutrition (MNA = 17), group 2 = 166 patients with risk of undernutrition (17 < MNA < 24), and group 3 = 291 patients without undernutrition (MNA = 24). Correlations with behavioral and psychological signs and symptoms of dementia (Neuropsychiatric Inventory NPI), with caregiver distress (Zarit), and with the Mini Mental State Examination (MMSE) were studied. Undernutrition is more frequently associated with low MMSE (p < 0.001), high behavioural disturbances (p < 0.001) and high distress of caregivers (p < 0.001). Risk of undernutrition is also associated with NPI (p < 0.001) and Zarit (p < 0.001). These first results in a French cohort of patients with AD underline the importance of the evaluation of nutritional status and finally the follow-up of eating behavior, cognitive status and the quality of life of the caregivers.
体重减轻在患有痴呆症的老年人中很常见，尤其是那些患有阿尔茨海默病（AD）的人，并且进食困难是该疾病后期护理中的主要问题。在这项研究（法国阿尔茨海默病研究网络的REAL FR）中，我们前瞻性地使用微型营养评定法（MNA）来检查479名受试者的营养状况。研究了三组患者：第1组 = 22名营养不良患者（MNA = 17），第2组 = 166名有营养不良风险的患者（17 < MNA < 24），第3组 = 291名无营养不良的患者（MNA = 24）。研究了与痴呆症的行为和心理症状体征（神经精神科问卷NPI）、与照料者苦恼（扎里特量表）以及与简易精神状态检查表（MMSE）之间的相关性。营养不良更常与低MMSE评分（p < 0.001）、高行为障碍（p < 0.001）和照料者的高度苦恼（p < 0.001）相关。营养不良风险也与NPI（p < 0.001）和扎里特量表（p < 0.001）相关。这些在法国AD患者队列中的初步结果强调了评估营养状况的重要性，最终也强调了对进食行为、认知状态和照料者生活质量的随访的重要性。
