Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan.
Medical Genome Center, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan.
Nutrients. 2019 Aug 20;11(8):1951. doi: 10.3390/nu11081951.
We examined the nutritional status and its association with behavioral psychiatric symptoms of dementia (BPSD) among 741 memory clinic patients (normal cognition (NC), 152; mild cognitive impairment (MCI), 271; early-stage Alzheimer disease (AD), 318). Nutritional status and BPSD were assessed using the Mini Nutritional Assessment Short-Form (MNA-SF) and the Dementia Behavior Disturbance Scale (DBD), respectively. Compared to subjects with NC, more subjects with MCI and early-stage AD were at risk of malnutrition (MNA-SF, 8-11: NC, 34.2%; MCI, 47.5%; early-stage AD, 53.8%) and were malnourished (MNA-SF, 0-7: NC, 4.6%; MCI, 5.9%; early-stage AD, 8.2%). Among patients with MCI or early-stage AD, those at risk of/with malnutrition showed higher DBD scores than those well-nourished (12.7 ± 9.0 vs. 9.5 ± 7.3; < 0.001). Moreover, analysis of covariance adjusting for confounders showed that nutritional status was significantly associated with specific BPSD, including "verbal aggressiveness/emotional disinhibition" (F = 5.87, = 0.016) and "apathy/memory impairment" (F = 15.38, < 0.001), which were revealed by factor analysis of DBD. Our results suggest that malnutrition is common among older adults with mild cognitive decline, and possibility that nutritional problems are associated with individual BPSD.
我们检查了 741 名记忆诊所患者（正常认知 (NC)，152 例；轻度认知障碍 (MCI)，271 例；早期阿尔茨海默病 (AD)，318 例）的营养状况及其与行为精神病学症状（BPSD）的关系。营养状况和 BPSD 分别采用 Mini Nutritional Assessment Short-Form (MNA-SF) 和 Dementia Behavior Disturbance Scale (DBD) 进行评估。与 NC 受试者相比，更多的 MCI 和早期 AD 受试者存在营养不良风险（MNA-SF，8-11：NC，34.2%；MCI，47.5%；早期 AD，53.8%）和营养不良（MNA-SF，0-7：NC，4.6%；MCI，5.9%；早期 AD，8.2%）。在 MCI 或早期 AD 患者中，存在营养不良风险/营养不良的患者的 DBD 评分高于营养良好的患者（12.7 ± 9.0 与 9.5 ± 7.3；<0.001）。此外，调整混杂因素的协方差分析显示，营养状况与特定的 BPSD 显著相关，包括“言语攻击/情绪抑制”（F = 5.87， = 0.016）和“淡漠/记忆障碍”（F = 15.38，<0.001），这是通过 DBD 的因子分析揭示的。我们的结果表明，轻度认知衰退的老年人中普遍存在营养不良，并且营养问题可能与个体的 BPSD 有关。
