Shatenstein Bryna, Kergoat Marie-Jeanne, Reid Isabelle
Départment de Nutrition, Université de Montréal, Montréal, Canada.
J Am Diet Assoc. 2007 Dec;107(12):2091-9. doi: 10.1016/j.jada.2007.09.008.
Decreased food intakes, eating behavior disturbances, and loss of body weight are particularly significant problems among those with Alzheimer dementia. To follow the natural evolution of dietary and nutrition status among elderly community-dwelling adults with Alzheimer dementia.
With their caregivers, 36 community-dwelling patients in early stages of Alzheimer dementia, aged > or =65 years, were recruited from memory clinics in Montréal, age-matched to cognitively intact community-based controls (n=58), and interviewed at four to five time points (T0 to T4) across an 18-month period. Current diet and supplement use were assessed monthly by two food records and/or 24-hour diet recalls (666 records/recalls from patients and 1,678 records/recalls from controls), using adapted data collection techniques among patients, and analyzed using CANDAT with the 2001b Canadian Nutrient File.
Nutrient intakes from diet and supplements were higher in control subjects, with significant differences in energy, the macronutrients, calcium, iron, zinc, vitamin K, vitamin A, and dietary fiber as well as n-3 and n-6 fatty acids. Repeated measures analysis of variance confirmed these observations among balanced groups of participants aged > or =70 years with full nutrient data during 12 months' follow-up.
Dietary intakes by persons with Alzheimer dementia are poor compared to cognitively intact age-matched controls. Suboptimal diet is evident early in the onset of the disease. This vulnerable population would benefit from systematic dietary assessment and intervention to prevent further deterioration in food consumption and increased nutritional risk.
食物摄入量减少、饮食行为紊乱和体重减轻是阿尔茨海默病患者中尤为突出的问题。旨在追踪社区居住的患有阿尔茨海默病的老年成年人的饮食和营养状况的自然演变。
从蒙特利尔的记忆诊所招募了36名年龄≥65岁、处于阿尔茨海默病早期阶段的社区居住患者及其照料者,与认知功能正常的社区对照者(n = 58)进行年龄匹配,并在18个月内的四到五个时间点(T0至T4)进行访谈。通过两份食物记录和/或24小时饮食回顾(患者提供666份记录/回顾,对照者提供1678份记录/回顾)每月评估当前饮食和补充剂的使用情况,对患者采用适应性数据收集技术,并使用CANDAT和2001b版加拿大营养档案进行分析。
对照者从饮食和补充剂中摄入的营养素更高,在能量、宏量营养素、钙、铁、锌、维生素K、维生素A、膳食纤维以及n-3和n-6脂肪酸方面存在显著差异。重复测量方差分析在年龄≥70岁、在12个月随访期间有完整营养数据的均衡参与者组中证实了这些观察结果。
与认知功能正常的年龄匹配对照者相比,阿尔茨海默病患者的饮食摄入量较差。在疾病发作早期就明显存在饮食欠佳的情况。这一脆弱人群将受益于系统的饮食评估和干预,以防止食物摄入量进一步下降和营养风险增加。