There is a lack of data on global weight loss prevention programs for patients with dementia or clear evidence about their impact on a functional level, caregiver burden or the use of healthcare and social resources. “NutriAlz” is a socio-educative and nutritional intervention program to prevent weight loss and loss of function in dementia patients.
Study Design and Methods
A cluster randomized multi-centre study, which will allow the comparison of a group benefiting from the intervention with a control group after a year of monitoring. Patients were recruited from 11 hospitals in the ambulatory diagnostic units and day care centres. The baseline interview include: sociodemographic and socioeconomic variables (age, gender, educational level, marital status); diagnostic, treatments, MMS, a list of comorbid conditions; activities of daily living (ADL, IADL), Zarit Scale, brief-NPI, Cornell scale and nutritional status as measured by the Mini Nutritional Assessment. All participants or their family signed the inform consent form.
Total of 946 patients were included, with a mean (± SD) of 79 ± 7.3 year of age; 68,1 % were women; 44,9% lives with their partner, only 3% lives alone; 79.8% had Alzheimer’s dementia, 5.25 ± 3.0 years since symptoms of dementia and 2.8 ± 2.11 years since diagnosis. Mean MMSE score was 15.4 ± 6.2; mean weight was 64.4 ± 12.5 kg; mean BMI was 27.0 ± 4.5 (with 3% below 19, 5% between 19–21, 10% between 21–23, and 82% above 23). Mean ADL without difficulties was 3.2± 2.1; mean IADL without difficulties was 0.7± 1.6; mean number of symptoms in the NPI was 4.4 ± 2.59, with severity score of 7.9 ± 5.9 and distress score of 11.3 ± 9.0; mean Zarit scale was 27.4 ± 15.5; mean MNA was 23.2 ± 3.5 with 5 % as malnourished, 32 % at risk of malnutrition, and 63 % with adequate nutritional status.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Melzer D, McWilliams B, Brayne C et al. Profile of disability in elderly people: estimates from a longitudinal population study. BMJ 1999 April 24;318(7191):1108–1111.
Ferri CP, Prince M, Brayne C et al. Global prevalence of dementia: a Delphi consensus study. Lancet 2005 December 17;366(9503):2112–2117.
World Health Organization. Neurological disorders: a public health approach (Dementia, Epilepsy, Headache disorders, Multiple sclerosis, Neuroinfections). In: World Health Organization, editor. Neurological Disorders: Public Health Challenges. WHO, WHO Press, 1211 Geneva 27, Switzerland, 2007. p. 41–110.
Bermejo-Pareja F, ito-Leon J, Vega S et al. Incidence and subtypes of dementia in three elderly populations of central Spain. Journal of the Neurological Sciences 2008 January 15;264(1–2):63–72.
Berr C, Wancata J, Ritchie K. Prevalence of dementia in the elderly in Europe. Eur Neuropsychopharmacol 2005 August;15(4):463–471.
Matthews F, Brayne C. The incidence of dementia in England and Wales: findings from the five identical sites of the MRC CFA Study. PLoS Med 2005 August;2(8):e193.
Xie J, Brayne C, Matthews FE, and the Medical Research Council Cognitive Function and Ageing Study collaborators. Survival times in people with dementia: analysis from population based cohort study with 14 year follow-up. BMJ 2008 February 2;336(7638):258–262.
Gillette-Guyonnet S, Nourhashemi F, Andrieu S et al. The REAL.FR research program on Alzheimer’s disease and its management: methods and preliminary results. J Nutr Health Aging 2003;7(2):91–96.
Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature—What does it tell us? J Nutr Health Aging 2006 November;10(6):466–485.
Andrieu S, Reynish W, Nourhashemi F et al. Nutritional risk factors for institutional placement in Alzheimer’s disease after one year follow-up. J Nutr Health Aging 2001;5(2):113–117.
Holm B, Soderhamn O. Factors associated with nutritional status in a group of people in an early stage of dementia. Clin Nutr 2003 August;22(4):385–389.
Suominen M, Laine A, Routasalo P et al. Nutrient content of served food, nutrient intake and nutritional status of residents with dementia in a finnish nursing home. J Nutr Health Aging 2004;8(4):234–238.
Bartali B, Frongillo EA, Bandinelli S et al. Low Nutrient Intake Is an Essential Component of Frailty in Older Persons. J Gerontol A Biol Sci Med Sci 2006 June 1;61(6):589–593.
White H, Pieper C, Schmader K, Fillenbaum G. Weight change in Alzheimer’s disease. J Am Geriatr Soc 1996 March;44(3):265–272.
White H, Pieper C, Schmader K. The association of weight change in Alzheimer’s disease with severity of disease and mortality: a longitudinal analysis. J Am Geriatr Soc 1998 October;46(10):1223–1227.
Cronin-Stubbs D, Beckett LA, Scherr PA et al. Weight loss in people with Alzheimer’s disease: a prospective population based analysis. BMJ 1997 January 18;314(7075):178.
Guerin O, Andrieu S, Schneider SM et al. Different modes of weight loss in Alzheimer disease: a prospective study of 395 patients. Am J Clin Nutr 2005 August 1;82(2):435–441.
Knopman DS, Edland SD, Cha RH et al. Incident dementia in women is preceded by weight loss by at least a decade. Neurology 2007 August 21;69(8):739–746.
Stewart R, Masaki K, Xue QL et al. A 32-Year Prospective Study of Change in Body Weight and Incident Dementia: The Honolulu-Asia Aging Study. Arch Neurol 2005 January 1;62(1):55–60.
Nourhashemi F, Deschamps V, Larrieu S et al. Body mass index and incidence of dementia: The PAQUID study. Neurology 2003 January 14;60(1):117–119.
Johnson DK, Wilkins CH, Morris JC. Accelerated Weight Loss May Precede Diagnosis in Alzheimer Disease. Arch Neurol 2006 September 1;63(9):1312–1317.
Wallace JI, Schwartz RS, LaCroix AZ et al. Involuntary weight loss in older outpatients: incidence and clinical significance. J Am Geriatr Soc 1995 April;43(4):329–337.
Ritchie CS, Locher JL, Roth DL et al. Unintentional Weight Loss Predicts Decline in Activities of Daily Living Function and Life-Space Mobility Over 4 Years Among Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci 2008 January 1;63(1):67–75.
Payette H, Coulombe C, Boutier V, Gray-Donald K. Nutrition risk factors for institutionalization in a free-living functionally dependent elderly population. Journal of Clinical Epidemiology 2000 June;53(6):579–587.
Sorbye LW, Schroll M, Finne SH et al. Unintended weight loss in the elderly living at home: the aged in Home Care Project (AdHOC). J Nutr Health Aging 2008 January;12(1):10–16.
Gillette-Guyonnet S, Nourhashemi F, Andrieu S et al. Weight loss in Alzheimer disease. Am J Clin Nutr 2000 February 1;71(2):637s–642s.
Tamura BK, Masaki KH, Blanchette P. Weight loss in patients with Alzheimer’s disease. J Nutr Elder 2007;26(3–4):21–38.
Gillette GS, Abellan Van KG, Alix E et al. IANA (International Academy on Nutrition and Aging) Expert Group: weight loss and Alzheimer’s disease. J Nutr Health Aging 2007 January;11(1):38–48.
Faxen-Irving G, ndren-Olsson B, Geijerstam A et al. Nutrition education for care staff and possible effects on nutritional status in residents of sheltered accomodation. Eur J Clin Nutr 2005 June 8;59(8):947–954.
Lauque S, Arnaud-Battandier F, Gillette S et al. Improvement of weight and fat-free mass with oral nutritional supplementation in patients with Alzheimer’s disease at risk of malnutrition: a prospective randomized study. J Am Geriatr Soc 2004 October;52(10):1702–1707.
Burgener SC, Buettner L, Coen BK et al. Evidence supporting nutritional interventions for persons in early stage Alzheimer’s disease (AD). J Nutr Health Aging 2008 January;12(1):18–21.
Riviere S, Gillette-Guyonnet S, Voisin T et al. A Nutritional Education Program Could Prevent Weight Loss and Slow Cognitive Decline in Alzheimer’s Disease. J Nutr Health Aging 2001;5(4):295–299.
Belmin J. Practical guidelines for the diagnosis and management of weight loss in Alzheimer’s disease: a consensus from appropriateness ratings of a large expert panel. J Nutr Health Aging 2007 January;11(1):33–37.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40(5):373–383.
Schneeweiss S, Wang PS, Avorn J, Glynn RJ. Improved comorbidity adjustment for predicting mortality in Medicare populations. Health Serv Res 2003 August;38(4):1103–1120.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician 769. Journal of Psychiatric Research 1975 November;12(3):189–198.
Morris JC. The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology 1993 November 1;43(11):2412–a.
Ousset PJ, Nourhashemi F, Reynish E, Vellas B. Nutritional Status is Associated With Disease Progression in Very Mild Alzheimer Disease. Alzheimer Dis Assoc Disord 2008 January;22(1):66–71.
Guigoz Y, Vellas B, Garry PJ. Mini nutritional assessment: A practical assessment tool for grading the nutritional state of elderly patients. Facts, Research in Gerontology 1994;(Suppl 2):15–59.
Vellas B, Guigoz Y, Garry PJ et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999 February;15(2):116–122.
Tully MW, Matrakas KL, Muir J, Musallam K. The Eating Behavior Scale. A simple method of assessing functional ability in patients with Alzheimer’s disease 773. J Gerontol Nurs 1997 July;23(7):9–15.
Tully MW, Lambros MK, Musallam K. The eating behavior scale: a simple method of assessing functional ability in patients with Alzheimer’s disease. J Nutr Health Aging 1998;2(2):119–121.
Cummings JL, Mega M, Gray K et al. The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia. Neurology 1994 December 1;44(12):2308.
Kaufer DI, Cummings JL, Ketchel P et al. Validation of the NPI-Q, a Brief Clinical Form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci 2000 May 1;12(2):233–239.
Boada M, Cejudo JC, Tarraga L et al. [Neuropsychiatric inventory questionnaire (NPI-Q): Spanish validation of an abridged form of the Neuropsychiatric Inventory (NPI)]. Neurologia 2002 June;17(6):317–323.
Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Cornell scale for depression in dementia 781. Biological Psychiatry 1988 February 1;23(3):271–284.
Camus V, Schmitt L, Ousset PJ, Micas M. [Depression and dementia: contribution to the French validation of 2 depression scales: the Cornell Scale for Depression in Dementia and the Dementia Mood Assessment Scale] 782. Encephale 1995 May;21(3):201–208.
Katz S, Ford AB, Moskowitz RW et al. Studies of illness in the aged: the Index of ADL, a standardized measure of biological and psychosocial function 786. JAMA 1963 September 21;185:914–919.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9(3):179–186.
Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Arch Gerontol Geriatr 2007 January;44(1):71–81.
Zarit SH, Todd PA, Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study 787. Gerontologist 1986 June;26(3):260–266.
Mollison J, Simpson JA, Campbell MK, Grimshaw JM. Comparison of analytical methods for cluster randomised trials: an example from a primary care setting. J Epidemiol Biostat 2000;5(6):339–348.
Nixon R, Prevost TC, Duffy SW et al. Some random-effects models for the analysis of matched-cluster randomised trials: application to the Swedish two-county trial of breast-cancer screening. J Epidemiol Biostat 2000;5(6):349–358.
Campbell MK, Elbourne DR, Altman DG. CONSORT statement: extension to cluster randomised trials. BMJ 2004 March 20;328(7441):702–708.
Nourhashemi F, Gillette-Guyonnet S, Andrieu S et al. A randomized trial of the impact of a specific care plan in 1120 Alzheimer’s patients (PLASA Study) over a two-year period: design and baseline data. J Nutr Health Aging 2008 April;12(4):263–271.
Reynish E, Cortes F, Andrieu S et al. The ICTUS Study: A Prospective longitudinal observational study of 1,380 AD patients in Europe. Study design and baseline characteristics of the cohort. Neuroepidemiology 2007;29(1–2):29–38.
About this article
Cite this article
Salva, A., Andrieu, S., Fernandez, E. et al. Health and nutritional promotion program for patients with dementia (nutrialz study): Design and baseline data. J Nutr Health Aging 13, 529–537 (2009). https://doi.org/10.1007/s12603-009-0103-0
- Alzheimer disease
- nutritional program