Buffa R, Mereu E, Putzu P, Mereu R M, Marini E
Department of Environmental and Life Sciences, University of Cagliari, Cittadella Universitaria, 09042 Monserrato, Italy.
Geriatric Division, SS Trinità Hospital, ASL 8, Cagliari, Italy.
Exp Gerontol. 2014 Oct;58:30-3. doi: 10.1016/j.exger.2014.07.005. Epub 2014 Jul 11.
In this study we analyzed body composition in relation to cognitive and functional status, in a cross-sectional sample of patients with Alzheimer's disease (AD). Seventy individuals (27 men, 78.1±6.5years; 43 women, 80.4±5.6years) with mild-moderate stages of AD (clinical dementia ratings 1 and 2) were selected from the Alzheimer Center, SS. Trinità Hospital, ASL 8 of Cagliari (Italy). Cognitive and psycho-functional status was evaluated using mini-mental state examination (MMSE), activities of daily living (ADL) scale, and geriatric depression scale (GDS). Mini-nutritional assessment (MNA) was applied. Anthropometric measurements were taken and body mass index (BMI) was calculated. Body composition was assessed by means of specific bioelectrical impedance vector analysis (BIVA), using the references for the elderly. In comparison with the reference group, patients with AD showed similar BMI and MNA, but peculiar bioelectrical characteristics: lower phase angles and longer vectors (p<0.05). According to specific BIVA, this bioelectrical pattern is indicative of a reduction of lean tissue mass and an increase of percent fat mass (FM%). A more accentuated lean mass reduction (p < 0.05) was observed in women with worse cognitive status and a FM% increase (p < 0.01) in women with worse functional status. In conclusion, patients with AD had lower lean tissue mass and higher percent fat mass than healthy elderly individuals. In women, this pattern was associated with cognitive and functional decline, as indicated by MMSE and ADL values. Specific BIVA showed to be a suitable technique in the elderly, that could enhance BMI and MNA information in the evaluation of nutritional status.
在本研究中，我们对阿尔茨海默病（AD）患者的横断面样本进行了身体成分与认知及功能状态关系的分析。从意大利卡利亚里市ASL 8的圣三一医院阿尔茨海默病中心选取了70名患有轻中度AD（临床痴呆评定为1级和2级）的个体（27名男性，年龄78.1±6.5岁；43名女性，年龄80.4±5.6岁）。使用简易精神状态检查表（MMSE）、日常生活活动（ADL）量表和老年抑郁量表（GDS）评估认知和心理功能状态。应用微型营养评定法（MNA）。进行人体测量并计算体重指数（BMI）。采用针对老年人的参考标准，通过特定的生物电阻抗矢量分析（BIVA）评估身体成分。与参考组相比，AD患者的BMI和MNA相似，但具有独特的生物电特征：相位角较低且矢量较长（p<0.05）。根据特定的BIVA，这种生物电模式表明瘦组织质量减少，脂肪质量百分比（FM%）增加。在认知状态较差的女性中观察到更明显的瘦组织质量减少（p < 0.05），在功能状态较差的女性中FM%增加（p < 0.01）。总之，与健康老年人相比，AD患者的瘦组织质量较低，脂肪质量百分比较高。在女性中，这种模式与MMSE和ADL值所表明的认知和功能衰退相关。特定的BIVA显示是一种适用于老年人的技术，在评估营养状况时可增强BMI和MNA信息。
