Nutritional and cognitive relationships and long-term mortality in patients with various dementia disorders.
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.


METHODS
prospective observational study.


METHODS
University Hospital.


METHODS
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.
Faxén-Irving
Gerd
G
Karolinska Institutet, Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden. gerd.faxen-irving@karolinska.se
Basun
Hans
H
Cederholm
Tommy
T
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D000886:Anthropometry; D015992:Body Mass Index; D003072:Cognition Disorders / Q000175:diagnosis* / Q000178:diet therapy / Q000401:mortality; D015897:Comorbidity; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000178:diet therapy / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D011502:Protein-Energy Malnutrition / Q000175:diagnosis* / Q000178:diet therapy / Q000209:etiology / Q000401:mortality; D015996:Survival Rate; D013548:Sweden; D016896:Treatment Outcome