Malnutrition is Associated with Behavioral and Psychiatric Symptoms of Dementia in Older Women with Mild Cognitive Impairment and Early-Stage Alzheimer's Disease.

Ai Kimura,Taiki Sugimoto,Takashi Sakurai,Kazuya Kitamori,Shumpei Niida,Naoki Saji,Kenji Toba

doi:10.3390/nu11081951

Abstract

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; p < 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, p = 0.016) and “apathy/memory impairment” (F = 15.38, p < 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.

Highlights

With the aging of the world’s population, the prevalence of dementia is rapidly increasing.Alzheimer’s disease (AD) is the most common type of dementia
Our results suggest that malnutrition is common among older adults with mild cognitive decline, and possibility that nutritional problems are associated with individual behavioral psychiatric symptoms of dementia (BPSD)
In order to examine the association between nutritional status and BPSD in patients with cognitive impairment, we focused on those with mild cognitive impairment (MCI) and early-stage AD

Summary

Introduction

With the aging of the world’s population, the prevalence of dementia is rapidly increasing. Alzheimer’s disease (AD) is the most common type of dementia. Given that no basic medical treatment of AD is established at present, prevention of onset of AD in patients at risk of the disease, as well as care of those with AD, remains the most urgent of challenges in clinical practice. Nutritional problems, notably weight loss, are frequently seen among patients with AD, especially those with moderate to severe AD. Nutritional problems are associated with adverse outcomes, such as rapid cognitive decline [1], a high rate of institutionalization [2], and increased mortality [3]. Most studies investigated nutritional status among patients with moderate to severe AD.

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