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韩国老年人群营养状况与认知阶段的关联:韩国阿尔茨海默病早期诊断与预测脑老化研究

Association of Nutritional Status with Cognitive Stage in the Elderly Korean Population: The Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease.

作者信息

Jang Jae Won, Kim Yeshin, Choi Yong Ho, Lee Jong Min, Yoon Bora, Park Kyung Won, Kim Si Eun, Kim Hee Jin, Yoon Soo Jin, Jeong Jee Hyang, Kim Eun Joo, Jung Na Yeon, Hwang Jihye, Kang Ju Hee, Hong Jin Yong, Choi Seong Hye

机构信息

Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea.

Department of Biomedical Engineering, Hanyang University, Seoul, Korea.

出版信息

J Clin Neurol. 2019 Jul;15(3):292-300. doi: 10.3988/jcn.2019.15.3.292.

Abstract

BACKGROUND AND PURPOSE

Epidemiological studies have suggested the presence of strong correlations among diet, lifestyle, and dementia onset. However, these studies have unfortunately had major limitations due to their inability to fully control the various potential confounders affecting the nutritional status. The purpose of the current study was to determine the nutritional status of participants in the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease (KBASE) and to identify clinical risk factors for being at risk of malnutrition or being malnourished.

METHODS

Baseline data from 212 participants [119 cognitively unimpaired (CU), 56 with mild cognitive impairment (MCI), and 37 with dementia] included in the KBASE database were analyzed. All participants underwent a comprehensive cognitive test and MRI at baseline. The presence of malnutrition at baseline was measured by the Mini Nutritional Assessment score. We examined the cross-sectional relationships of clinical findings with nutritional status using multiple logistic regression applied to variables for which <0.2 in the univariate analysis. Differences in cortical thickness according to the nutritional status were also investigated.

RESULTS

After adjustment for demographic, nutritional, and neuropsychological factors, participants with dementia had a significantly higher odds ratio (OR) for being at risk of malnutrition or being malnourished than CU participants [OR=5.98, 95% CI=1.20-32.97] whereas participants with MCI did not (OR=0.62, 95% CI=0.20-1.83). Cortical thinning in the at-risk/malnutrition group was observed in the left temporal area.

CONCLUSIONS

Dementia was found to be an independent predictor for the risk of malnutrition compared with CU participants. Our findings further suggest that cortical thinning in left temporal regions is related to the nutritional status.

摘要

背景与目的

流行病学研究表明饮食、生活方式与痴呆症发病之间存在密切关联。然而,遗憾的是,这些研究存在重大局限性,因为它们无法完全控制影响营养状况的各种潜在混杂因素。本研究的目的是确定韩国阿尔茨海默病早期诊断与预测脑老化研究(KBASE)参与者的营养状况,并识别存在营养不良风险或已营养不良的临床危险因素。

方法

分析了KBASE数据库中212名参与者的基线数据[119名认知未受损(CU)者、56名轻度认知障碍(MCI)者和37名痴呆症患者]。所有参与者在基线时均接受了全面的认知测试和MRI检查。通过微型营养评定量表得分来衡量基线时是否存在营养不良。我们使用多因素逻辑回归分析单因素分析中P<0.2的变量,以研究临床结果与营养状况之间的横断面关系。还研究了根据营养状况划分的皮质厚度差异。

结果

在对人口统计学、营养和神经心理学因素进行调整后,与CU参与者相比,痴呆症患者存在营养不良风险或已营养不良的比值比(OR)显著更高[OR=5.98,95%CI=1.20-32.97],而MCI参与者则不然(OR=0.62,95%CI=0.20-1.83)。在有风险/营养不良组中,左侧颞叶区域观察到皮质变薄。

结论

与CU参与者相比,痴呆症被发现是营养不良风险的独立预测因素。我们的研究结果进一步表明,左侧颞叶区域的皮质变薄与营养状况有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01ff/6620466/0f1d64f7119f/jcn-15-292-g001.jpg

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