title: An open-ended question: Alzheimer's disease and involuntary weight loss: which comes first?
abstract: OBJECTIVE
  After the onset of Alzheimer's disease (AD), a substantial percentage of patients experience involuntary weight loss (IWL), but there is some debate as to whether IWL is a cause or a consequence of AD. It may play a causal role, because nutritional deficiencies have been found to be associated with worsened cognitive performance, even in subjects without dementia. Conversely, it may be an effect of the disease, considering the hypothesis that the neurodegenerative process associated with AD may itself lead to IWL. The aim of the present review was to help to shed some light on the relationship between IWL and AD.
  
  
  METHODS
  We focus on the problem of the relationship between AD and IWL, and on which comes first.
  
  
  RESULTS
  Even when external factors are well controlled, the association between IWL and the progression of AD seems, for the time being, to be unavoidable.
  
  
  CONCLUSIONS
  In the light of the literature on the topic, we conclude that IWL is more a consequence than a cause of AD, although chronic diseases and disabilities are factors that may facilitate cognitive decline and accelerate the onset of AD if they are not adequately treated from the nutritional standpoint.
authors: Department of Medical and Surgical Sciences, University of Padova, 35128 Padova, Italy. eminemeral.inelmen@unipd.it
authors: Emine M
authors: EM
authors: Inelmen
authors: Giuseppe
authors: G
authors: Sergi
authors: Alessandra
authors: A
authors: Coin
authors: Agostino
authors: A
authors: Girardi
authors: Enzo
authors: E
authors: Manzato
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications* / Q000503:physiopathology*; D005247:Feeding Behavior / Q000502:physiology*; D006801:Humans; D015596:Nutrition Assessment; D015431:Weight Loss / Q000502:physiology*