Neuroscience Research Australia, Sydney, Australia2Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia3ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia.
Neuroscience Research Australia, Sydney, Australia3ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia4School of Psychology, The University of New South Wales, Sydney, Australia.
JAMA Neurol. 2014 Dec;71(12):1540-6. doi: 10.1001/jamaneurol.2014.1931.
Presence of eating abnormalities is one of the core criteria for the diagnosis of behavioral variant frontotemporal dementia (bvFTD), yet their occurrence in other subtypes of frontotemporal dementia (FTD) and effect on metabolic health is not known.
To define and quantify patterns of eating behavior and energy, sugar, carbohydrate, protein, and fat intake, as well as indices of metabolic health in patients with bvFTD and semantic dementia (SD) compared with patients with Alzheimer disease (AD) and healthy control participants.
DESIGN, SETTING, AND PARTICIPANTS: Prospective case-controlled study involving patient and caregiver completion of surveys. Seventy-five participants with dementia (21 with bvFTD, 26 with SD, and 28 with AD) and 18 age- and education-matched healthy controls were recruited from FRONTIER, the FTD research clinic at Neuroscience Research Australia in Sydney.
Caregivers of patients with FTD and AD completed validated questionnaires on appetite, eating behaviors, energy consumption, and dietary macronutrient composition. All participants completed surveys on hunger and satiety. Body mass index and weight measurements were prospectively collected.
The bvFTD group had significant abnormalities in the domains of appetite (U = 111.0, z = 2.7, P = .007), eating habits (U = 69.5, z = 3.8, P = .001), food preferences (U = 57.0, z = 4.1, P = .001), swallowing (U = 109.0, z = 3.0, P = .003), and other oral behaviors (U = 141.0, z = 2.6, P = .009) compared with the AD group. The bvFTD and SD groups tended to have increased energy consumption. Compared with controls, the bvFTD group had significantly increased carbohydrate intake (251 vs 170 g/d; P = .05) and the SD group had significantly increased sugar intake (114 vs 76 g/d; P = .049). No significant differences in total fat or protein intake between the groups were found. Despite similar energy intake, the SD group had lower hunger and satiety scores compared with the bvFTD group. In contrast, hunger and satiety scores did not differ between the bvFTD group and controls. The abnormal eating behavior was found in the 2 groups (bvFTD and SD) with the highest body mass index (F = 4.2, P = .008) and waist circumference (F = 6.4, P = .001).
Abnormal eating behaviors are prominent in patients with bvFTD and those with SD and are not limited to increased appetite. The observed higher intake of sugar and carbohydrates was found in patients with the FTD subtypes and those with higher body mass index and waist circumference and was not explained simply by increased hunger or lower satiety.
饮食异常是行为变异额颞叶痴呆（bvFTD）诊断的核心标准之一，但其他额颞叶痴呆（FTD）亚型中饮食异常的发生情况及其对代谢健康的影响尚不清楚。
本研究旨在定义和量化 bvFTD 和语义性痴呆（SD）患者的饮食行为和能量、糖、碳水化合物、蛋白质和脂肪摄入模式，以及代谢健康指标，与阿尔茨海默病（AD）患者和健康对照组进行比较。
设计、地点和参与者：这是一项前瞻性病例对照研究，包括患者和护理人员完成的调查。75 名痴呆患者（21 名 bvFTD、26 名 SD 和 28 名 AD）和 18 名年龄和教育程度匹配的健康对照者从澳大利亚悉尼神经科学研究澳大利亚的 FTD 研究诊所 FRONTIER 招募。
FTD 和 AD 患者的护理人员完成了关于食欲、饮食行为、能量消耗和饮食宏量营养素组成的验证问卷。所有参与者都完成了关于饥饿感和饱腹感的调查。前瞻性收集体重指数和体重测量数据。
与 AD 组相比，bvFTD 组在食欲（U = 111.0，z = 2.7，P =.007）、饮食习惯（U = 69.5，z = 3.8，P =.001）、食物偏好（U = 57.0，z = 4.1，P =.001）、吞咽（U = 109.0，z = 3.0，P =.003）和其他口腔行为（U = 141.0，z = 2.6，P =.009）方面存在明显异常。与对照组相比，bvFTD 和 SD 组的能量消耗增加。与对照组相比，bvFTD 组的碳水化合物摄入量显著增加（251 比 170 g/d；P =.05），SD 组的糖摄入量显著增加（114 比 76 g/d；P =.049）。组间总脂肪或蛋白质摄入量无显著差异。尽管能量摄入相似，但 SD 组的饥饿感和饱腹感评分明显低于 bvFTD 组。相比之下，bvFTD 组和对照组的饥饿感和饱腹感评分没有差异。在 2 组（bvFTD 和 SD）中观察到异常的饮食行为，这些患者的体重指数（F = 4.2，P =.008）和腰围（F = 6.4，P =.001）最高。
bvFTD 和 SD 患者存在明显的饮食行为异常，并且不限于食欲增加。在 FTD 亚型和体重指数以及腰围较高的患者中发现了较高的糖和碳水化合物摄入量，这不能简单地用饥饿感增加或饱腹感降低来解释。
