Uchida Nozomu, Ishida Mayumi, Sato Izumi, Yoshioka Akira, Takahashi Takao, Furuya Daisuke, Ebihara Yasuhiro, Ito Hiroshi, Onishi Hideki
Department of General Medicine Ogano Town Central Hospital Saitama Japan.
Department of Psycho-oncology Saitama Medical University International Medical Center Saitama Japan.
J Gen Fam Med. 2023 Feb 14;24(3):148-153. doi: 10.1002/jgf2.609. eCollection 2023 May.
Although thiamine deficiency (TD) can lead to Wernicke encephalopathy, the characteristics associated with TD in the elderly have not yet been clarified. We sought to clarify the frequency of TD among an institutionalized elderly population with a controlled dietary intake and to identify possible factors related to TD.
We undertook a cross-sectional study of residents in three nursing homes for the elderly as of June 2020. Blood thiamine concentrations were measured using a high-performance liquid chromatography method, with TD defined as a concentration of <21.3 ng/mL. Basic data (age, sex, height, weight, and BMI), dietary intake for the previous 3 weeks, degree of care (DOC), degree of independence in daily life for elderly with dementia (DIDLED), and comorbidities were analyzed using descriptive statistical methods.
The mean age (±SD) was 86.9 years (±8.29), with 84 residents (70.0%) being female. The DIDLED varied from total independence to long-term care level 5 (full assistance), with 89.2% suffering dementia. The mean whole blood thiamine value was 36.18 (±17.58) ng/ml, with TD confirmed in 7 (5.8%) of the 120 residents. All TD patients suffered from dementia. No TD was observed in patients with a near-normal food intake, and no related factors were observed among the other items.
Reduced food intake may at increase the risk of TD and symptoms of TD may be overlooked in those displaying symptoms of dementia; thus, it is important for clinicians working with the elderly to remain aware of the potential for TD.
尽管硫胺素缺乏（TD）可导致韦尼克脑病，但老年人TD的相关特征尚未明确。我们旨在明确饮食摄入受控的机构养老老年人群中TD的发生率，并确定与TD相关的可能因素。
我们对截至2020年6月的三家养老院的老年居民进行了横断面研究。采用高效液相色谱法测定血硫胺素浓度，TD定义为浓度<21.3 ng/mL。使用描述性统计方法分析基本数据（年龄、性别、身高、体重和BMI）、前3周的饮食摄入量、护理程度（DOC）、痴呆老年人的日常生活独立程度（DIDLED）和合并症。
平均年龄（±标准差）为86.9岁（±8.29），84名居民（70.0%）为女性。DIDLED从完全独立到长期护理5级（完全协助）不等，89.2%的人患有痴呆症。全血硫胺素平均水平为36.18（±17.58）ng/ml，120名居民中有7名（5.8%）确诊为TD。所有TD患者均患有痴呆症。食物摄入量接近正常的患者未观察到TD，其他项目中也未观察到相关因素。
食物摄入量减少可能会增加TD的风险，而痴呆症状患者中TD的症状可能会被忽视；因此，老年科临床医生应意识到TD的可能性，这一点很重要。
