title: The relationship of weight change trajectory with medial temporal lobe atrophy in patients with mild Alzheimer's disease: results from a cohort study.
abstract: BACKGROUND
  Weight loss has been described in 20% to 45% of patients with Alzheimer's disease (AD) and has been associated with adverse outcomes. Various mechanisms for weight loss in AD patients have been proposed, though none has been proven. This study aimed to elucidate a mechanism of weight loss in AD patients by examining the hypothesis that weight loss is associated with medial temporal lobe atrophy (MTA).
  
  
  METHODS
  Patients from the Frisian Alzheimer's disease cohort study (a retrospective, longitudinal study of 576 community-dwelling AD patients) were included when a brain MRI was performed on which MTA could be assessed. To investigate the hypothesis that weight loss is associated with MTA, we investigated whether the trajectory of body weight change depends on the severity of MTA at the time of diagnosis (that is baseline). We hypothesized that patients with more severe MTA at baseline would have a lower body weight at baseline and a faster decrease in body weight during the course of the disease. The generalized linear mixed model (GLMM) was used to determine the relationship of weight change trajectory with MTA severity.
  
  
  RESULTS
  In total, 214 patients (median age 79 years, median MMSE 23, mean weight 73.9 kg) were included. Patients with moderate, severe or very severe MTA at baseline weighed 3.2 to 6.8 kg more than patients with no or mild MTA. During the 3.5 years, patients gained on average 1.7 kg in body weight, irrespective of the severity of their MTA at baseline.
  
  
  CONCLUSIONS
  We found no evidence that MTA is associated with weight loss in AD patients. Moreover, contrary to what was expected, AD patients did not lose but gained weight during follow-up.
authors.affiliation: Department of Geriatric Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, the Netherlands.
authors.forename: Erika
authors.initials: E
authors.lastname: Droogsma
authors.affiliation: Department of Geriatric Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, the Netherlands.
authors.forename: Dieneke
authors.initials: D
authors.lastname: van Asselt
authors.affiliation: Department of Geriatric Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, the Netherlands.
authors.forename: Hanneli
authors.initials: H
authors.lastname: Bieze
authors.affiliation: Department of Epidemiology, Medical Center Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, the Netherlands ; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands.
authors.forename: Nic
authors.initials: N
authors.lastname: Veeger
authors.affiliation: Department of Neurology and Alzheimer Research Center, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands ; Department of Neurology and Memory Clinic, ZNA and Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Antwerp Belgium.
authors.forename: Peter Paul
authors.initials: PP
authors.lastname: De Deyn
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