Shinagawa Shunichiro, Adachi Hiroyoshi, Toyota Yasutaka, Mori Takaaki, Matsumoto Izumi, Fukuhara Ryuji, Ikeda Manabu
Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan.
Int Psychogeriatr. 2009 Jun;21(3):520-5. doi: 10.1017/S1041610209008631. Epub 2009 Mar 4.
Eating problems occur frequently in patients with dementia, and almost half of all patients with Parkinson's disease have such problems. It has therefore been assumed that eating problems are also common in patients with dementia with Lewy bodies (DLB). However, few systematic studies have investigated eating problems in DLB patients. The aim of this study was to clarify the frequency and characteristics of eating problems in patients with DLB.
We examined 29 consecutive patients with DLB and 33 with Alzheimer's disease (AD) in terms of age, sex, education, Mini-mental State Examination, clinical dementia rating (CDR), neuropsychiatric inventory (NPI), Unified Parkinson disease rating scale (UPDRS), fluctuations in cognition, and usage of neuroleptic drugs / antiparkinsonian drugs. We employed a comprehensive questionnaire comprising 40 items and compared the scores between the two groups.
DLB patients showed significantly higher scores than AD patients for "difficulty in swallowing foods," "difficulty in swallowing liquids," "coughing or choking when swallowing," "taking a long time to swallow," "suffering from sputum," "loss of appetite," "need watching or help," and "constipation". Only the UPDRS score significantly affected the scores for "difficulty in swallowing foods," "taking a long time to swallow" and "needs watching or help" score, whereas only the NPI score affected the score for "loss of appetite." The scores for UPDRS, NPI and CDR significantly affected the scores for "difficulty in swallowing liquids." No significant independent variables affected the scores for "coughing or choking when swallowing," "suffering from sputum" and "constipation."
Although DLB patients show many eating problems, the causes of each problem vary, and the severity of dementia or Parkinsonism is not the only determinant.
饮食问题在痴呆患者中经常出现，几乎一半的帕金森病患者存在此类问题。因此，人们认为路易体痴呆（DLB）患者中饮食问题也很常见。然而，很少有系统研究调查DLB患者的饮食问题。本研究的目的是明确DLB患者饮食问题的发生率及特征。
我们对29例连续的DLB患者和33例阿尔茨海默病（AD）患者进行了年龄、性别、教育程度、简易精神状态检查表、临床痴呆评定量表（CDR）、神经精神科问卷（NPI）、统一帕金森病评定量表（UPDRS）、认知波动以及抗精神病药物/抗帕金森病药物使用情况的检查。我们采用了一份包含40项内容的综合问卷，并比较了两组的得分。
DLB患者在“吞咽食物困难”“吞咽液体困难”“吞咽时咳嗽或呛噎”“吞咽时间长”“有痰液”“食欲不振”“需要照看或帮助”以及“便秘”等方面的得分显著高于AD患者。仅UPDRS得分对“吞咽食物困难”“吞咽时间长”和“需要照看或帮助”的得分有显著影响，而仅NPI得分对“食欲不振”的得分有影响。UPDRS、NPI和CDR得分对“吞咽液体困难”的得分有显著影响。没有显著的独立变量影响“吞咽时咳嗽或呛噎”“有痰液”和“便秘”的得分。
尽管DLB患者存在许多饮食问题，但每个问题的原因各不相同，痴呆或帕金森症的严重程度并非唯一的决定因素。
