Sanders Chelsea, Behrens Stephanie, Schwartz Sarah, Wengreen Heidi, Corcoran Chris D, Lyketsos Constantine G, Tschanz JoAnn T
Department of Psychology, Utah State University, Logan, UT, USA.
Department of Mathematics and Statistics, Utah State University, Logan, UT, USA.
J Alzheimers Dis. 2016 Feb 27;52(1):33-42. doi: 10.3233/JAD-150528.
Nutritional status may be a modifiable factor in the progression of dementia. We examined the association of nutritional status and rate of cognitive and functional decline in a U.S. population-based sample. Study design was an observational longitudinal study with annual follow-ups up to 6 years of 292 persons with dementia (72% Alzheimer's disease, 56% female) in Cache County, UT using the Mini-Mental State Exam (MMSE), Clinical Dementia Rating Sum of Boxes (CDR-sb), and modified Mini Nutritional Assessment (mMNA). mMNA scores declined by approximately 0.50 points/year, suggesting increasing risk for malnutrition. Lower mMNA score predicted faster rate of decline on the MMSE at earlier follow-up times, but slower decline at later follow-up times, whereas higher mMNA scores had the opposite pattern (mMNA by time β= 0.22, p = 0.017; mMNA by time2 β= -0.04, p = 0.04). Lower mMNA score was associated with greater impairment on the CDR-sb over the course of dementia (β= 0.35, p < 0.001). Assessment of malnutrition may be useful in predicting rates of progression in dementia and may provide a target for clinical intervention.
营养状况可能是痴呆症进展中一个可改变的因素。我们在美国一个基于人群的样本中研究了营养状况与认知和功能衰退率之间的关联。研究设计为一项观察性纵向研究，对犹他州卡什县的292名痴呆症患者（72%为阿尔茨海默病，56%为女性）进行了长达6年的年度随访，使用简易精神状态检查表（MMSE）、临床痴呆评定量表总和（CDR-sb）和改良的微型营养评定量表（mMNA）。mMNA评分每年下降约0.50分，表明营养不良风险增加。较低的mMNA评分在早期随访时预测MMSE评分下降速度更快，但在后期随访时下降速度较慢，而较高的mMNA评分则呈现相反的模式（mMNA与时间的β值=0.22，p=0.017；mMNA与时间平方的β值=-0.04，p=0.04）。在痴呆症病程中，较低的mMNA评分与CDR-sb上更严重的损害相关（β=0.35，p<0.001）。评估营养不良可能有助于预测痴呆症的进展速度，并可能为临床干预提供一个靶点。
