BackgroundWeight loss in patients with Alzheimer's disease (AD) is a common clinical manifestation that may have clinical significance.ObjectivesTo evaluate if there is a difference between nutrition education and oral nutritional supplementation on nutritional status in patients with AD.MethodsA randomized, prospective 6-month study which enrolled 90 subjects with probable AD aged 65 years or older divided into 3 groups: Control Group (CG) [n = 27], Education Group (EG) [n = 25], which participated in an education program and Supplementation Group (SG) [n = 26], which received two daily servings of oral nutritional supplementation. Subjects were assessed for anthropometric data (weight, height, BMI, TSF, AC and AMC), biochemical data (total protein, albumin, and total lymphocyte count), CDR (Clinical Dementia Rating), MMSE (Mini-mental state examination), as well as dependence during meals.ResultsThe SG showed a significant improvement in the following anthropometric measurements: weight (H calc = 22.12, p =< 0.001), BMI (H calc = 22.12, p =< 0.001), AC (H calc = 12.99, p =< 0.002), and AMC (H calc = 8.67, p =< 0.013) compared to the CG and EG. BMI of the EG was significantly greater compared to the CG. There were significant changes in total protein (H calc = 6.17, p =< 0.046), and total lymphocyte count in the SG compared to the other groups (H cal = 7.94, p = 0.019).ConclusionOral nutritional supplementation is more effective compared to nutrition education in improving nutritional status.
An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH) is likely to be beneficial for the patient. The objective of this paper is to present methods for evaluating the nutritional status of patients with severe dementia as well as measures for the treatment of nutritional disorders, the use of vitamin and mineral supplementation, and indications for ANH and pharmacological therapy.
Alzheimer's disease corresponds to 50-70% of all dementia syndromes, classified as a progressive neurodegenerative disease showing diffuse cortical atrophy with three stages of evolution: mild, moderate, and severe. Behavioral symptoms and memory loss are major manifestations of the disease. Non-pharmacological interventions are essential to improve the quality of life of these patients. Interdisciplinary assistance is essential throughout the disease course. Regarding nutrition for patients with Alzheimer's disease, weight loss and behavioral changes related to food are major objects of scientific study, as they trigger deterioration of the quality of life of patients and caregivers. Knowing which nutritional guidelines should be used helps in clinical decisions. The study of nutrition in dementia is, therefore, critical for patient management.
Higher BMI and creatinine clearance are protective regarding cognitive and functional decline for women, whereas higher cognitive reserve may lead to faster decline in instrumental functionality. APOE haplotypes affected the age at AD onset, but not cognitive or functional decline.
Purpose: to verify the correlation of the ingested diet with the nutritional status of Alzheimer disease (AD) patients; observation of fiber and fluid consumption and intestinal function.Methods: Cross-sectional study with 77 patients of both genders and their caregivers who were referred to nutritional status care in the three phases (CDR) of the AD. All answered the food anamnesis where it was possible to establish the amount of calories, macronutrients and micronutrients. Anthropometric measurements of weight, height, BMI, AC, TSF and AMC were collected.For the continuous variables, a descriptive statistical analysis was performed and for the analytical statistic the Poisson regression was used.Results: Most of the patients were eutrophic. The studied macronutrients were found to be adequate, except for the protein intake that was higher in the mild phase. No group achieved fiber intake. It was not found significant correlations between fiber consumption and intestinal function. In relation to micronutrients, adequate consumption of iron, vitamins A and B12 were found. Vitamin C intake did not reach DRI in mild patients and zinc consumption was low for patients who belonged to the group with moderated patients.
Conclusions:Although it does not reflect the nutritional reality of Brazilian patients with probable AD, this study provided important characteristics of the diet composition that already allow us to establish nutritional action strategies.
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