title: Nutritional Status is Associated with Faster Cognitive Decline and Worse Functional Impairment in the Progression of Dementia: The Cache County Dementia Progression Study1.
abstract: Nutritional status may be a modifiable factor in the progression of dementia. We examined the association of nutritional status and rate of cognitive and functional decline in a U.S. population-based sample. Study design was an observational longitudinal study with annual follow-ups up to 6 years of 292 persons with dementia (72% Alzheimer's disease, 56% female) in Cache County, UT using the Mini-Mental State Exam (MMSE), Clinical Dementia Rating Sum of Boxes (CDR-sb), and modified Mini Nutritional Assessment (mMNA). mMNA scores declined by approximately 0.50 points/year, suggesting increasing risk for malnutrition. Lower mMNA score predicted faster rate of decline on the MMSE at earlier follow-up times, but slower decline at later follow-up times, whereas higher mMNA scores had the opposite pattern (mMNA by time β= 0.22, p = 0.017; mMNA by time2 β= -0.04, p = 0.04). Lower mMNA score was associated with greater impairment on the CDR-sb over the course of dementia (β= 0.35, p <  0.001). Assessment of malnutrition may be useful in predicting rates of progression in dementia and may provide a target for clinical intervention.
authors.affiliation: Department of Psychology, Utah State University, Logan, UT, USA.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Sanders
authors.affiliation: Department of Psychology, Utah State University, Logan, UT, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Behrens
authors.affiliation: Department of Mathematics and Statistics, Utah State University, Logan, UT, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schwartz
authors.affiliation: Department of Nutrition and Food Sciences, Utah State University, Logan, UT, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Wengreen
authors.affiliation: Department of Mathematics and Statistics, Utah State University, Logan, UT, USA.|Center for Epidemiologic Studies, Utah State University, Logan, UT, USA.
authors.forename: Chris D
authors.initials: CD
authors.lastname: Corcoran
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Bayview, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.affiliation: Department of Psychology, Utah State University, Logan, UT, USA.|Center for Epidemiologic Studies, Utah State University, Logan, UT, USA.
authors.forename: JoAnn T
authors.initials: JT
authors.lastname: Tschanz
mesh_terms: D017668:Age of Onset; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000378:metabolism*; D015140:Dementia, Vascular / Q000453:epidemiology* / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D009752:Nutritional Status; D012720:Severity of Illness Index; D012737:Sex Factors; D014589:Utah / Q000453:epidemiology
keywords: Cognitive symptoms; dementia; disease progression; malnutrition; nutrition assessment