Nutritional Status Is Associated With Clinical Progression in Alzheimer's Disease: The NUDAD Project
Nutritional Status Is Associated With Clinical Progression in Alzheimer's Disease: The NUDAD Project
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DOI：
10.1016/j.jamda.2020.10.020
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发表时间：
2023-04-27
影响因子：
7.6
通讯作者：
Visser, Marjolein
中科院分区：
文献类型：
--
作者：
Doorduijn, Astrid S.;de van der Schueren, Marian A. E.;Visser, Marjolein
目的：在认知功能正常的成年人中，营养参数与认知功能下降和痴呆的发病率有关。缺乏关于营养在痴呆前阶段主观认知下降和轻度认知障碍以及阿尔茨海默病（AD）痴呆的轻度阶段中的作用的临床研究。在缺乏治愈性治疗的情况下，这一证据对于靶向营养因素以潜在地预防或延迟进一步的认知能力下降是重要的。我们的目的是调查从认知正常到AD痴呆患者的营养参数与临床进展的关系。设计：纵向。设置和参与者：记忆诊所，551例患者（219例主观认知下降，135例轻度认知障碍，197例AD痴呆），平均年龄64 ± 8岁。我们在基线时使用荷兰健康饮食食物频率问卷和238项城市健康生活（HELIUS）食物频率问卷评估体重指数、去脂体重、迷你营养评估和饮食摄入。采用考克斯比例风险模型评价营养参数与临床进展的相关性。额外的分析仅限于淀粉样蛋白阳性的患者。结果：我们观察到170例（31%）超过2.2 +/- 0.9年的临床进展。Postry微型营养评估评分[风险比（95%置信区间）1.39（1.18-1.64）]，较低的体重指数[1.15（0.96-1.38）]，低去脂质量[1.40（0.93-2.10）]和不太健康的饮食模式[1.22（1.01-1.48）]与较高的临床进展风险相关。类似的效果大小被发现在患者中谁是淀粉样蛋白阳性。结论和影响：POLYMPHOCYTE的营养状况和不健康的饮食模式与临床进展的风险较高。这项研究为研究改善营养状况是否可以改变AD的临床轨迹提供了支持。(c)2020年，任作家。爱思唯尔公司出版代表AMDA -急性后和长期护理医学协会。这是CC BY许可下的开放获取文章（http：//creativecommons.org/licenses/by/4.0/）。
Objective: In cognitively normal adults, nutritional parameters are related to cognitive decline and incidence of dementia. Studies on the role of nutrition in predementia stages subjective cognitive decline and mild cognitive impairment, and mild stages of Alzheimer's disease (AD) dementia in a clinical setting are lacking. In the absence of a curative treatment, this evidence is important for targeting nutritional factors to potentially prevent or delay further cognitive decline. Our aim is to investigate associations of nutritional parameters with clinical progression in patients ranging from those who are cognitively normal to those who have AD dementia.Design: Longitudinal.Setting and Participants: Memory clinic, 551 patients (219 with subjective cognitive decline, 135 with mild cognitive impairment, and 197 with AD dementia), mean age 64 +/- 8 years.Measurements: We assessed body mass index, fat-free mass, Mini-Nutritional Assessment, and dietary intake with the Dutch Healthy Diet food frequency questionnaire and the 238-item healthy life in an urban setting (HELIUS) food frequency questionnaire at baseline. Cox proportional hazard models were used to evaluate associations of nutritional parameters with clinical progression. Additional analyses were restricted to patients who were amyloid positive.Results: We observed clinical progression in 170 patients (31%) over 2.2 +/- 0.9 years. Poorer Mini-Nutritional Assessment score [hazard ratio (95% confidence interval) 1.39 (1.18-1.64)], lower body mass index [1.15 (0.96-1.38)], lower fat-free mass [1.40 (0.93-2.10)], and a less healthy dietary pattern [1.22 (1.01-1.48)] were associated with a higher risk of clinical progression. Similar effect sizes were found in patients who were amyloid positive.Conclusions and Implications: Poorer nutritional status and a less healthy dietary pattern are associated with a higher risk of clinical progression. This study provides support for investigating whether improving nutritional status can alter the clinical trajectory of AD.(c) 2020 The Authors. Published by Elsevier Inc. on behalf of AMDA -The Society for Post-Acute and Long-Term Care Medicine. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).