Centre for Age-Related Medicine (SESAM), Stavanger University Hospital. Stavanger, Norway.
Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.
J Alzheimers Dis. 2021;79(4):1713-1722. doi: 10.3233/JAD-200961.
In dementia, functional status depends on multiple factors in addition to cognition. Nutritional status is a potentially modifiable factor related to homeostasis and proper functioning of body systems and may contribute to cognitive and functional decline.
This paper aims to analyze the association of malnutrition with the course of cognitive and functional decline in people living with dementia.
This is an analysis of a longitudinal cohort study, the Dementia Study of Western Norway. Data of 202 patients diagnosed with mild dementia were analyzed; Alzheimer's disease (AD) (n = 103), Lewy body dementia (LBD) (n = 74), and other dementias (OD) (n = 25). Cognition was assessed with the Mini-Mental State Examination and functional decline through the activities of daily living included in the Rapid Disability Rating Scale. The Global Leadership Initiative on Malnutrition Index was used to determine nutritional status. Associations of nutritional status with cognitive and functional decline were evaluated through adjusted linear mixed models.
At baseline, the prevalence of general malnutrition was 28.7%; 17.3% were classified as moderate malnutrition and 11.38% as severe malnutrition (there were no significant differences between AD and LBD). Malnutrition at diagnosis and over follow-up was a significant predictor of functional-decline, but not of cognitive decline.
According to our results malnutrition was associated with faster functional loss but, not cognitive decline in older adults with dementia. A more comprehensive dementia approach including nutritional assessments could improve prognosis.
在痴呆症中，除认知能力外，功能状态还取决于多种因素。营养状况是与体内平衡和身体系统正常功能相关的一个潜在可改变的因素，可能导致认知和功能下降。
本文旨在分析营养不良与痴呆症患者认知和功能下降过程的关系。
这是一项对纵向队列研究（挪威西部痴呆症研究）的分析。分析了 202 名轻度痴呆症患者的数据；阿尔茨海默病（AD）（n=103）、路易体痴呆症（LBD）（n=74）和其他痴呆症（OD）（n=25）。认知评估采用简易精神状态检查，功能下降通过日常生活活动中包括的快速残疾评定量表进行评估。采用全球领导力倡议营养不良指数来确定营养状况。通过调整线性混合模型评估营养状况与认知和功能下降的关系。
基线时，一般营养不良的患病率为 28.7%；17.3%被归类为中度营养不良，11.38%为重度营养不良（AD 和 LBD 之间无显著差异）。诊断时和随访期间的营养不良是功能下降的显著预测因素，但不是认知下降的预测因素。
根据我们的结果，营养不良与老年人痴呆症患者的更快的功能丧失相关，但与认知下降无关。更全面的痴呆症方法包括营养评估可以改善预后。
