Berlinger W G, Potter J F
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68105.
J Am Geriatr Soc. 1991 Oct;39(10):973-8. doi: 10.1111/j.1532-5415.1991.tb04043.x.
In order to determine the association between dementia and low body weight in outpatients, Body Mass Index (BMI) was evaluated prospectively in 346 frail elderly outpatients presenting for comprehensive geriatric assessment. Patients were categorized into four groups (cognitively intact, dementia of the Alzheimer's type (DAT), other dementia, and patients with depressive symptoms). Patients were assessed for severity of dementia by the Clinical Dementia Rating scale. Differences between groups for various clinical parameters were evaluated using an analysis of variance and Duncan's Multiple Range Test. Patients with dementia, regardless of etiologic type or severity, and patients with depressive symptoms had BMI's greater than or equal to 10% lower than the cognitively intact patients. BMI was positively correlated with Instrumental Activities of Daily Living (IADL) but not Activities of Daily Living (ADL) or Mini-Mental State Exam (MMSE) score. Low BMI was not associated with increased physical illness. In fact, in the subset of patients with DAT, lower BMI correlated with significantly lesser amounts of comorbid physical illness. Finally, compared to cognitively intact outpatients, patients with DAT appeared to be physically healthier despite their having a lower BMI. These results suggest an association between dementia and low BMI. On the other hand, the presence of comorbid physical illness, a common focus of evaluation in these patients, was not more common in those patients with lower BMI's.
为了确定门诊患者中痴呆与低体重之间的关联，我们对346名前来进行综合老年评估的体弱门诊老年患者进行了前瞻性的体重指数（BMI）评估。患者被分为四组（认知功能正常、阿尔茨海默病型痴呆（DAT）、其他痴呆以及有抑郁症状的患者）。通过临床痴呆评定量表评估患者痴呆的严重程度。使用方差分析和邓肯多重极差检验评估各组之间各种临床参数的差异。痴呆患者，无论病因类型或严重程度如何，以及有抑郁症状的患者，其BMI比认知功能正常的患者低10%或更多。BMI与工具性日常生活活动能力（IADL）呈正相关，但与日常生活活动能力（ADL）或简易精神状态检查表（MMSE）评分无关。低BMI与身体疾病增加无关。事实上，在DAT患者亚组中，较低的BMI与合并身体疾病的数量显著较少相关。最后，与认知功能正常的门诊患者相比，DAT患者尽管BMI较低，但身体似乎更健康。这些结果表明痴呆与低BMI之间存在关联。另一方面，在这些患者中作为常见评估重点的合并身体疾病，在BMI较低的患者中并不更常见。
