title: Nutritional status according to the stages of Alzheimer's disease.
abstract: OBJECTIVE
  To assess the nutritional status of Alzheimer's disease (AD) patients with no other associated dementia, according to disease stage.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Neurobehavioral Diseases Outpatient Clinic, Clinical Hospital, Ribeirao Preto Medical School (University of São Paulo).
  
  
  METHODS
  The sample consisted of 36 individuals of both genders with AD diagnosis, and no other associated type of dementia, in various stages of the disease, according to the Clinical Dementia Rating (CDR 0.5-3).
  
  
  METHODS
  Nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and anthropometric measurements such as weight, body mass index (BMI) and arm, waist, abdomen and hip circumferences. In addition, body composition was assessed by bioelectrical impedance analysis (BIA).
  
  
  RESULTS
  The mean age of the group was 74.2 ± 10.1 years, 72.2 % of them were women. The MNA showed that most of these individuals were at risk for malnutrition (55.5 %) and many of them (43.7 %) were underweight according to BMI. Data from BIA analysis revealed that 41.7 % of these individuals had a quantity of body fat classified as malnutrition and 11.1 % had a phase angle (PA) below recommended values for age group. There was a negative and significant correlation of lean mass and PA with age, and of global MNA evaluation with CDR, as well as a positive correlation of MNA total score with fat mass and BMI. Worse classifications of nutritional status obtained by MNA scores were also observed in the more severe stages of the disease, according to the CDR.
  
  
  CONCLUSIONS
  Patients with AD are mostly elderly with changes in body composition that are typical of aging, with signs of peripheral malnutrition and preservation of abdominal fat. However, greater impairment of general nutritional status was observed in the more advanced stages of AD, creating a situation of greater vulnerability for these patients.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto (FMRP), University of São Paulo (USP), São Paulo, Brazil, larys_marino@yahoo.com.br.
authors.forename: Larissa Vieira
authors.initials: LV
authors.lastname: Marino
authors.forename: Liliana Figueiredo Andrade de Oliveira
authors.initials: LF
authors.lastname: Ramos
authors.forename: Paula Garcia
authors.initials: PG
authors.lastname: Chiarello
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000503:physiopathology; D000818:Animals; D001823:Body Composition; D015992:Body Mass Index; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D062072:Patient Acuity