Department of Medical and Surgical Sciences, Division of Geriatrics, University of Padova, Padova, Italy.
J Nutr Health Aging. 2012;16(6):553-6. doi: 10.1007/s12603-012-0052-x.
The body mass index (BMI) is commonly used to assess nutritional status and the Mini Mental State Examination (MMSE) is a validated tool for assessing cognitive status in elderly people. Nutritional and cognitive aspects are closely related in dementia.
To establish whether BMI predicts cognitive decline in demented patients and whether an "alarm" BMI cut-off exists for declining MMSE scores.
82 elderly demented patients underwent clinical, bio-chemical and functional assessment.
Transversal study.
The mean BMI was 26.08±4.48 kg/m² and the mean MMSE 18.68±5.38. Patients with BMI<25 kg/m² had significantly lower MMSE scores (16.5±5.53 vs 20.38±4.64; p 0.001), fat-free mass (FFM; 27.76±8.99 vs 37.38±10.58 kg; p<0.001), fat-free mass index (FFMI; 11.52±3.03 vs 14.67±2.89 kg/m²; p<0.001), and fat mass (FM; 24.90±6.89 vs 36.86±6.77 kg; p<0.001), as well as lower Mini Nutritional Assessment (MNA) scores (23.80±2.50 vs 25.00±2.29; p=0.03) and higher vitamin B12 levels (460.95±289.80 vs 332.43±82.07 pg/ml; p=0.01). In the sample as a whole, MMSE scores significantly correlated with scores for MNA (r=0.27, p=0.01), FFM (r=0.27, p=0.01), BMI (r=0.19, p=0.05), ADL (r=0.28, p=0.01) and instrumental activities of daily living (IADL; r=0.34, p=0.002). On multiple logistic regression, BMI<25 kg/m² was independently associated with the risk of moderate-severe cognitive impairment (OR=2.96; 95% CI; 1.16-7.55) and female gender was independently associated with severity of dementia (OR=3.14; 95% CI; 1.09-9.03).
BMI seems to indicate global health status in elderly demented people and a BMI of 25 kg/m² can be considered an "alarm" cut-off, lower values coinciding with a worse cognitive status based on MMSE scores.
体重指数（BMI）常用于评估营养状况，而迷你精神状态检查（MMSE）是评估老年人认知状态的有效工具。营养和认知在痴呆症中密切相关。
确定 BMI 是否可预测痴呆患者的认知下降，以及是否存在“警示”BMI 临界值，可预测 MMSE 评分下降。
82 名老年痴呆症患者接受了临床、生物化学和功能评估。
横断面研究。
平均 BMI 为 26.08±4.48 kg/m²，平均 MMSE 为 18.68±5.38。BMI<25 kg/m² 的患者 MMSE 评分显著降低（16.5±5.53 与 20.38±4.64；p<0.001），无脂肪质量（FFM；27.76±8.99 与 37.38±10.58 kg；p<0.001），FFMI（11.52±3.03 与 14.67±2.89 kg/m²；p<0.001），以及脂肪质量（FM；24.90±6.89 与 36.86±6.77 kg；p<0.001），以及较低的 Mini 营养评估（MNA）评分（23.80±2.50 与 25.00±2.29；p=0.03）和较高的维生素 B12 水平（460.95±289.80 与 332.43±82.07 pg/ml；p=0.01）。在整个样本中，MMSE 评分与 MNA（r=0.27，p=0.01）、FFM（r=0.27，p=0.01）、BMI（r=0.19，p=0.05）、ADL（r=0.28，p=0.01）和工具性日常生活活动（IADL；r=0.34，p=0.002）评分显著相关。在多元逻辑回归中，BMI<25 kg/m² 与中重度认知障碍的风险独立相关（OR=2.96；95%CI；1.16-7.55），女性与痴呆严重程度独立相关（OR=3.14；95%CI；1.09-9.03）。
BMI 似乎反映了老年痴呆症患者的整体健康状况，BMI 为 25 kg/m² 可视为“警示”临界值，值较低表明 MMSE 评分下降与认知状态较差相关。
