title: Differences in nutritional status between very mild Alzheimer's disease patients and healthy controls.
abstract: BACKGROUND
  Studies on the systemic availability of nutrients and nutritional status in Alzheimer's disease (AD) are widely available, but the majority included patients in a moderate stage of AD.
  
  
  OBJECTIVE
  This study compares the nutritional status between mild AD outpatients and healthy controls.
  
  
  METHODS
  A subgroup of Dutch drug-naïve patients with mild AD (Mini-Mental State Examination (MMSE) ≥20) from the Souvenir II randomized controlled study (NTR1975) and a group of Dutch healthy controls were included. Nutritional status was assessed by measuring levels of several nutrients, conducting the Mini Nutritional Assessment (MNA®) questionnaire and through anthropometric measures.
  
  
  RESULTS
  In total, data of 93 healthy cognitively intact controls (MMSE 29.0 [23.0-30.0]) and 79 very mild AD patients (MMSE = 25.0 [20.0-30.0]) were included. Plasma selenium (p < 0.001) and uridine (p = 0.046) levels were significantly lower in AD patients, with a similar trend for plasma vitamin D (p = 0.094) levels. In addition, the fatty acid profile in erythrocyte membranes was different between groups for several fatty acids. Mean MNA screening score was significantly lower in AD patients (p = 0.008), but not indicative of malnutrition risk. No significant differences were observed for other micronutrient or anthropometric parameters.
  
  
  CONCLUSIONS
  In non-malnourished patients with very mild AD, lower levels of some micronutrients, a different fatty acid profile in erythrocyte membranes and a slightly but significantly lower MNA screening score were observed. This suggests that subtle differences in nutrient status are present already in a very early stage of AD and in the absence of protein/energy malnutrition.
authors.affiliation: Radboud Alzheimer Center, Department of Geriatric Medicine, Radboud University Hospital, Nijmegen, The Netherlands.
authors.forename: Marcel G M
authors.initials: MG
authors.lastname: Olde Rikkert
authors.affiliation: Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Frans R
authors.initials: FR
authors.lastname: Verhey
authors.affiliation: Nutricia Research, Utrecht, The Netherlands.
authors.forename: John W C
authors.initials: JW
authors.lastname: Sijben
authors.affiliation: Neurology Department, Catharina Ziekenhuis, Eindhoven, The Netherlands.
authors.forename: Femke H
authors.initials: FH
authors.lastname: Bouwman
authors.affiliation: Geriatrics Department, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, The Netherlands.
authors.forename: Paul L J
authors.initials: PL
authors.lastname: Dautzenberg
authors.affiliation: Nutricia Research, Utrecht, The Netherlands.
authors.forename: Mirian
authors.initials: M
authors.lastname: Lansink
authors.affiliation: Department of Geriatric Medicine, Orbis Medisch Centrum, Sittard, The Netherlands.
authors.forename: Walther M W
authors.initials: WM
authors.lastname: Sipers
authors.affiliation: Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Dieneke Z B
authors.initials: DZ
authors.lastname: van Asselt
authors.affiliation: Nutricia Research, Utrecht, The Netherlands.
authors.forename: Anneke M J
authors.initials: AM
authors.lastname: van Hees
authors.affiliation: Neurology Department, Tergooiziekenhuizen Blaricum, Blaricum, The Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Stevens
authors.affiliation: Gerontopole, INSERM U 1027, Toulouse, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.affiliation: Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000378:metabolism*; D000886:Anthropometry; D001774:Blood Chemical Analysis; D002462:Cell Membrane / Q000378:metabolism; D004912:Erythrocytes / Q000378:metabolism; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000097:blood*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009483:Neuropsychological Tests; D009752:Nutritional Status / Q000502:physiology*; D011502:Protein-Energy Malnutrition / Q000453:epidemiology / Q000378:metabolism; D012643:Selenium / Q000097:blood; D011795:Surveys and Questionnaires; D014529:Uridine / Q000097:blood; D014807:Vitamin D / Q000097:blood
chemical_list: D005227:Fatty Acids; D018977:Micronutrients; D014807:Vitamin D; D012643:Selenium; D014529:Uridine
keywords: Alzheimer's disease; fatty acids; healthy volunteers; micronutrients; nutritional status; protein-energy malnutrition