营养状况与认知衰退和新发神经认知障碍的风险：新加坡纵向老龄化研究。
Nutritional Status and Risks of Cognitive Decline and Incident Neurocognitive Disorders: Singapore Longitudinal Ageing Studies.
机构信息
Tze Pin Ng, Gerontology Research Programme and Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 9th Floor, 1E Kent Ridge Road, Singapore 119228, Fax: 65-67772191, Tel: 65-67723478, Email:
出版信息
J Nutr Health Aging. 2021;25(5):660-667. doi: 10.1007/s12603-021-1603-9.
BACKGROUND
Studies suggest that nutritional interventions using the whole diet approach such as the Mediterranean diet may delay cognitive decline and dementia onset. However, substantial numbers of older adults are non-adherent to any ideally healthy dietary pattern and are at risk of malnutrition.
OBJECTIVE
The present study investigated the relationship between global malnutrition risk and onsets of cognitive decline and neurocognitive disorders (NCD), including mild cognitive impairment (MCI) or dementia in community-dwelling older adults.
METHODS
Participants aged ≥ 55 years in the Singapore Longitudinal Ageing Studies (SLAS) were assessed at baseline using the Elderly Nutritional Indicators for Geriatric Malnutrition Assessment (ENIGMA) and followed up 3-5 years subsequently on cognitive decline (MMSE drop ≥ 2) among 3128 dementia-free individuals, and incident neurocognitive disorders (NCD) among 2640 cognitive normal individuals.
RESULTS
Individuals at high nutritional risk score (≥ 3) were more likely to develop cognitive decline (OR=1.42, 95%CI=1.01-1.99) and incident MCI-or-dementia (OR=1.64, 95%CI=1.03-2.59), controlling for age, sex, ethnicity, low education, APOE-e4, hearing loss, physical, social, and mental activities, depressive symptoms, smoking, alcohol, central obesity, hypertension, diabetes, low HDL, high triglyceride, cardiac disease, and stroke. Among ENIGMA component indicators, low albumin at baseline was associated with cognitive decline and incident NCD, and 5 or more drugs used, few fruits/vegetables/milk products daily, and low total cholesterol were associated with incident NCD.
CONCLUSION
The ENIGMA measure of global malnutrition risk predicts cognitive decline and incident neurocognitive disorders, suggesting the feasibility of identifying vulnerable subpopulations of older adults for correction of malnutrition risk to prevent neurocognitive disorders.
背景
研究表明，采用整体饮食方法的营养干预措施，如地中海饮食，可能有助于延缓认知能力下降和痴呆的发生。然而，大量老年人无法坚持任何理想的健康饮食模式，存在营养不良的风险。
目的
本研究旨在调查整体营养风险与认知能力下降和神经认知障碍（NCD）发病的关系，包括轻度认知障碍（MCI）或痴呆，在社区居住的老年人中。
方法
新加坡纵向老龄化研究（SLAS）中的年龄≥55 岁的参与者在基线时使用老年人营养指标进行老年营养不良评估（ENIGMA），并在 3-5 年内对 3128 名无痴呆症的个体进行认知下降（MMSE 下降≥2）的随访，以及 2640 名认知正常的个体进行神经认知障碍（NCD）的发病随访。
结果
营养风险评分较高（≥3）的个体更有可能出现认知能力下降（OR=1.42，95%CI=1.01-1.99）和 MCI 或痴呆的发病（OR=1.64，95%CI=1.03-2.59），控制了年龄、性别、种族、低教育水平、APOE-e4、听力损失、身体、社会和精神活动、抑郁症状、吸烟、饮酒、中心性肥胖、高血压、糖尿病、低 HDL、高甘油三酯、心脏病和中风。在 ENIGMA 组成指标中，基线时低白蛋白与认知能力下降和 NCD 发病有关，而使用 5 种或更多药物、每日水果/蔬菜/奶制品摄入量少以及总胆固醇低与 NCD 发病有关。
结论
ENIGMA 整体营养风险测量预测认知能力下降和神经认知障碍发病，表明识别老年人群中易受营养风险影响的亚群，以纠正营养风险，预防神经认知障碍是可行的。
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