Age and Ageing Advance Access originally published online on January 11, 2005
Age and Ageing 2005 34(2):136-141; doi:10.1093/ageing/afi023
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Age and Ageing Vol. 34 No. 2 © British Geriatrics Society 2005; all rights reserved
Research Paper |
Nutritional and cognitive relationships and long-term mortality in patients with various dementia disorders
1 Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden
2 Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
3 Clinical Science, AstraZeneca, Södertälje, Sweden
Address correspondence to: G. Faxén-Irving, Department of Geriatric Medicine, B 56, Karolinska University Hospital, Huddinge, SE-14186 Stockholm, Sweden. Fax: (+46) 858 586 075. Email: gerd.faxen-irving{at}karolinska.se
Abstract
Background: subjects with dementia are at risk for protein-energy malnutrition.
Objective: to study the nutritional status, the short-term effects of adapted nutritional routines and the long-term mortality in subjects admitted for evaluation of cognitive dysfunction.
Design: prospective observational study.
Setting: University Hospital.
Subjects: a total of 231 patients (80 ± 7 years, 65% women).
Methods: Body mass index (BMI, kg/m2), serum concentrations of albumin, ferritin, vitamin B12, folic acid and haemoglobin as well as Mini-Mental State Examination (MMSE, 0–30 p) results and co-morbidity were recorded at hospital admittance and before discharge. Seven years later, mortality was registered.
Results: mean BMI was in the normal range (23.3 ± 4) as were the biochemical indices, and they did not vary among patients with Alzheimer’s disease (AD), vascular dementia (VaD), mild cognitive impairment, mixed dementia and other diagnoses. A BMI of <23 was found in 108 (52%) subjects. Weight and MMSE score correlated weakly (r = 0.18, P < 0.01) at inclusion. During a median hospital stay of 3 weeks, an average weight gain of 0.5 ± 1.8 kg (P < 0.001) and an increase in MMSE score of 0.9 ± 3 (P < 0.001) was observed. However, these changes did not correlate. A BMI of <23 was associated with an increased risk for 7-year mortality (OR 3, 95% CI = 1.3–6.7), which was independent of age, male gender, dementia diagnosis and co-morbidity.
Conclusions: nutritional status did not vary in patients with various dementia diagnoses. A BMI of <23 was related to reduced 7-year survival, but this result was independent of co-morbidity, male gender and age.
Keywords: Alzheimer’s disease, cognition, dementia, nutrition, survival, elderly
Received April 8, 2004; Revision received November 10, 2004. accepted in revised form November 10, 2004.
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