Accelerated weight loss may precede diagnosis in Alzheimer disease
Accelerated weight loss may precede diagnosis in Alzheimer disease
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DOI：
10.1001/archneur.63.9.1312
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发表时间：
2006-09-01
影响因子：
--
通讯作者：
Morris, John C.
中科院分区：
文献类型：
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作者：
Johnson, David K.;Wilkins, Consuelo H.;Morris, John C.
目的：确定老年人体重减轻与阿尔茨海默型痴呆（DAT）发病的关系，并描述老年人体重随时间变化的速率（年龄65-95岁）发展DAT的人与没有痴呆的人。设计：在老年研究参与者（N = 449）中调查了体重变化率在华盛顿大学医学院阿尔茨海默病研究中心，这些人被登记为无痴呆的对照受试者，并进行纵向随访（平均6年）。一些人（n = 125）最终发展DAT;其他人（n = 324）仍然没有痴呆。在每次年度评估时测量体重。分段线性回归和随机效应模型被用来测试组间的纵向体重变化率。结果：没有痴呆症的参与者每年损失约0.6磅。对于那些发展DAT的人，在检测DAT之前大约1年，体重减轻的速度翻了一番（每年1.2磅）。作为一个群体，最终发展DAT的参与者体重较轻，（约8磅）结论：有和没有DAT的衰老与体重减轻有关;然而，在诊断DAT之前，体重减轻可能会加速。导致体重减轻的具体因素尚不清楚，但这些数据表明，它们在DAT发展之前就开始起作用了。因此，体重减轻可能是阿尔茨海默病的临床前指标。
Objectives: To determine the association of weight loss and the onset of dementia of the Alzheimer type (DAT) and to characterize the rate of weight change over time in older adults (aged 65-95 years) who develop DAT vs those who remain without dementia.Design: Rates of weight change were investigated in older adult research participants (N = 449) who were enrolled as control subjects without dementia and followed up longitudinally (6 years on average) at the Alzheimer's Disease Research Center, Washington University School of Medicine. Some individuals (n = 125) eventually developed DAT; the others (n = 324) remained without dementia. Body weight was measured at each annual assessment. Piecewise linear regression and random effects models were used to test longitudinal rates of weight change between the groups.Results: Participants without dementia lost about 0.6 lb per year. For those individuals who developed DAT, about 1 year before the detection of DAT, the rate of weight loss doubled (1.2 lb per year). As a group, participants who eventually developed DAT weighed less (about 8 pounds) at study enrollment (ie, when they did not have dementia) than participants who remained without dementia.Conclusions: Aging with and without DAT is associated with weight loss; however, weight loss may accelerate before the diagnosis of DAT. Specific factors contributing to weight loss are unknown, but these data suggest they operate before the development of DAT. Hence, weight loss may be a preclinical indicator of Alzheimer disease.