Nutritional interventions in community-dwelling Alzheimer patients with (risk of) undernutrition: a systematic review.
BACKGROUND
Weight loss and undernutrition are common in patients with Alzheimer's disease (AD) and associated with negative health outcomes. In the current guidelines on diagnosis and treatment of AD, no recommendations for treatment of (risk of) undernutrition in community-dwelling AD patients are given.


METHODS
We conducted a systematic review on the effect of nutritional interventions in community-dwelling AD patients with (risk of) undernutrition, according to the methods outlined by the Cochrane Collaboration. Three electronic databases and three trial registers were searched from inception till April 2013.


RESULTS
Literature search in the electronic databases yielded 546 records of which one was relevant for this review. This study, with a high risk of bias, demonstrated that oral nutritional supplements improved nutritional outcomes without effect on clinical and biochemical outcomes. The search in the trial registers yielded 369 records of which two were relevant. One trial was terminated because of failing inclusion, the other is ongoing.


CONCLUSIONS
This systematic review on the effect of nutritional interventions in community-dwelling AD patients with (risk of) undernutrition, reveals a serious lack of evidence. Therefore, it is not possible to state what the best approach is.
Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
Erika
E
Droogsma
Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
Dieneke
D
van Asselt
Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
Jolanda
J
van Steijn
Department of Epidemiology, Medical Center Leeuwarden, Leeuwarden, the Netherlands.|Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Nic
N
Veeger
Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
Ingeborg
I
van Dusseldorp
Department of Neurology and Alzheimer Research Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.|Department of Neurology and Memory Clinic, ZNA and Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
Peter Paul
PP
De Deyn
D006801:Humans; D000544:Alzheimer Disease / Q000178:diet therapy; D044342:Malnutrition / Q000178:diet therapy / Q000628:therapy; D019587:Dietary Supplements; D000368:Aged; D057187:Independent Living; D009752:Nutritional Status
Alzheimer’s disease; community-dwelling; nutritional intervention; systematic review; undernutrition