Age and Ageing Advance Access published online on January 11, 2005
Age and Ageing, doi:10.1093/ageing/afi023
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1 Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
* To whom correspondence should be addressed. 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.
Received April 8, 2004
Accepted November 10, 2004
Article
Nutritional and cognitive relationships and long-term mortality in patients with various dementia disorders
2 Clinical Science, AstraZeneca, Södertälje, Sweden
Gerd Faxén-Irving, E-mail: gerd.faxen-irving{at}karolinska.se
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