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Nutritional assessment of demented patients: A descriptive study

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Abstract

Background and aims: It is well-known that subclinical and overt malnutrition are strong predictive indices of morbidity and mortality in old subjects, particularly in demented ones, and may deeply affect the quality of life. The aim of this study was evaluation of nutritional status in demented patients, as a whole and according to type of dementia, at the moment of hospital admission and before discharge. Methods: The study concerns 174 old demented patients, aged 80.2±8 SD, diagnosed as having Alzheimer’s disease, vascular dementia, degenerative and vascular dementia, reversible dementia, and other types of dementia. In each subject, anthropometric measures, body composition analysis by the bioelectric impedance technique, Mini Nutritional Assessment (MNA) and cognitive, functional and affective assessment by conventional geriatric instruments were performed. A blood sample allowed assay of the main biochemical nutritional markers. At the end of the hospitalization period, the same cognitive, functional and nutritional assessment was repeated, in order to evaluate the effects of vitamin and protein supplements and of care during meals. Results: In all subgroups of demented patients, obtained according to type of dementia, the mean MNA score was indicative of risk for malnutrition. Furthermore, the MNA score was significantly related to severe cognitive impairment, functional status, comorbidity, BMI values, and transferrin and total protein serum levels. Malnourished patients and demented elderly at risk for malnutrition (according to the MNA score) were given oral nutritional supplements during hospitalization, lasting a mean of 45 days. Before discharge, these two subtypes of demented patients showed substantial maintenance of their cognitive, functional and nutritional status, whereas the subgroup of well-nourished demented patients exhibited significant worsening of the nutritional pattern. Conclusions: Demented patients show a high percentage of malnutrition, particularly evident in subjects with deeper cognitive impairment. Nutritional status seems to be linked more to functional abilities than to duration of disease. However, nutritional intervention or special care during meals may act in synergy with specific pharmacologic therapy of dementia.

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References

  1. Fernandez F, Probst M, Meerman R, Vandereyckes W. Body size estimation and body dissatisfaction in eating disorder patients and normal controls. Int J Eat Disord 1994; 16: 307–10.

    Article  PubMed  CAS  Google Scholar 

  2. Guyonnet S, Nourhasemi F, Andrieu S, et al. A prospective study of changes in nutritional status of Alzheimer’s patients. Arch Gerontol Geriatr 1998; Suppl. 1: 255–62.

    Google Scholar 

  3. Singh S, Mulley GP, Losowsky MS. Why are Alzheimer’s patients thin? Age Aging 1998; 17: 21–8.

    Article  Google Scholar 

  4. Barrett-Connor E, Eldestein SL, Corey-Bloom J, Wiederholt WC. Weight loss precedes dementia in community-dwelling older adults. J Am Geriatr Soc 1996; 44: 1147–52.

    PubMed  CAS  Google Scholar 

  5. Grundman M, Corey-Bloom J, Jernigan T, Archibald S, Thal LJ. Low body mass index and mesial temporal cortex atrophy in Alzheimer’s disease. In Vellas B, Riviere S, Eds. Research and practice in Alzheimer’s disease. Broadway, NY: Springer Pub. Co., 1998; 37–8.

    Google Scholar 

  6. Sandman PO, Adolfsson R, Nygren C, Hallmans G, Winblad B. Nutritional status and dietary intake in institutionalized patients with Alzheimer’s disease and multiinfarct dementia. J Am Geriatr Soc 1987; 35: 31–8.

    PubMed  CAS  Google Scholar 

  7. Renvall MJ, Spindler AA, Ramsdell JW, Paskvan M. Nutritional status of free-living Alzheimer’s patients. Am J Med Sci 1989; 298: 20–6.

    Article  PubMed  CAS  Google Scholar 

  8. Prentice AM, Leavesly K, Murgatroyd PR, et al. Is severe wasting in elderly mental patients caused by an excessive energy requirement? Age Aging 1989; 18: 158–67.

    Article  CAS  Google Scholar 

  9. Poehlman E, Dvorak R. Energy expenditure in Alzheimer’s disease. In Vellas B, Riviere S. Eds. Research and practice in Alzheimer’s disease. Broadway, NY: Springer Pub. Co., 1998: 36–46.

    Google Scholar 

  10. Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. In Vellas BJ, Guigoz Y, Garry PJ, Albarede JL, Eds. Facts and research in gerontology, 19941995; Suppl: 15–59.

  11. MNA. Available at: http://www.mna-elderly.com

  12. Mc Khann G, Drachman D, Folstein M, Katzman R, Price D, Standlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 1984; 34: 939–44.

    Article  CAS  Google Scholar 

  13. Romàn GC, Tatanuchi TK, Erkinjutti Y, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993; 43: 250–60.

    Article  PubMed  Google Scholar 

  14. Hughes CB, Berg L, Danziger W. A new clinical scale for the staging of dementia. Br J Psychiatry 1992; 140: 566–72.

    Article  Google Scholar 

  15. Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.

    Article  PubMed  CAS  Google Scholar 

  16. Sheikh JI, Yasevage JA. A knowledge assessment test for geriatric psychiatry. Hosp Community Psychiatry 1985; 36: 1160–6.

    PubMed  CAS  Google Scholar 

  17. Cummings JL, Mega M, Gray K, Rosemberg-Thompson S, Carusi DA, Gornbein J. The neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308–14.

    Article  PubMed  CAS  Google Scholar 

  18. Chumlea WC, Roche AF, Steinbaugh ML. Anthropometric approaches to the nutritional assessment of the elderly. In Munro HN, Danford DE, Eds. Nutrition, aging, and the elderly. New York: Plenum Press, 1989: 335–61.

    Chapter  Google Scholar 

  19. Chumlea WC, Vellas BJ, Roche AF, Guo S, Steinbaugh M. Particularity and interest for anthropometric measurements of the nutritional status of elderly. Age Nutr 1990; 1: 7–12.

    Google Scholar 

  20. StatSoft: Available at: http://www.statsoft.com

  21. Bianchetti A, Rozzini R, Carabellese C, Zanetti O, Trabucchi M. Nutritional intake, socioeconomic conditions, and health status in a large elderly population. J Am Geriatr Soc 1990; 38: 521–6.

    PubMed  CAS  Google Scholar 

  22. Cederholm T, Hellstrom K. Nutrition status in recently hospitalized and free-living elderly subjects. Gerontology 1992; 38: 105–10.

    Article  PubMed  CAS  Google Scholar 

  23. Dwyer JT, Coleman KA, Krall E, et al. Changes in relative weight among instituzionalized elderly adults. J Gerontol 1987; 42: 246–51.

    Article  PubMed  CAS  Google Scholar 

  24. Sullivan DH, Patch GA, Walls RC, Lipschitz DA. Impact of nutrition status on morbility and mortality in a select population of geriatric rehabilitation patients. Am J Clin Nutr 1990; 51: 749–58.

    PubMed  CAS  Google Scholar 

  25. Pinchcofsky-Devin GD, Kaminsky MV Jr. Correlation of pressure sores and nutritional status. J Am Geriatr Soc 1986; 34: 435–40.

    PubMed  CAS  Google Scholar 

  26. Bianchetti A, Boffelli S. Stato nutrizionale e demenza: una interazione complessa. Dementia Update 3, January 1999.

  27. White H. Weight change in Alzheimer’s disease. In Vellas B, Riviere S, Eds. Research and practice in Alzheimer’s disease. Broadway, NY: Springer Pub. Co., 1998: 31–6.

    Google Scholar 

  28. Morales-Rodriguez P, Gonzalez-Reimers E, Santolaria-Fernandez F, Batista-Lopez N, Gonzalez-Reyes A. Functional decline and nutritional status in a hospitalized geriatric population: sequential study. Nutrition 1990; 6: 469–73.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine and Medical Therapy, Chair of Geriatrics, University of Pavia, Piazza Borromeo 2, 27100, Pavia, Italy

    Flavia Magri M.D., Angela Borza, Stefania del Vecchio, Spyridon Chytiris, Giovanni Cuzzoni, Lorena Busconi, Anna Rebesco & Ettore Ferrari

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  1. Flavia Magri M.D.
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  2. Angela Borza
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  3. Stefania del Vecchio
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  4. Spyridon Chytiris
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  5. Giovanni Cuzzoni
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  6. Lorena Busconi
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  7. Anna Rebesco
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  8. Ettore Ferrari
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Correspondence to Flavia Magri M.D..

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Magri, F., Borza, A., del Vecchio, S. et al. Nutritional assessment of demented patients: A descriptive study. Aging Clin Exp Res 15, 148–153 (2003). https://doi.org/10.1007/BF03324493

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