Low Body Mass Index in Demented Outpatients

Abstract

In order to determine the association between dementia and low body weight in outpatients, Body Mass Index (BMI) was evaluated prospectively in 346 frail elderly outpatients presenting for comprehensive geriatric assessment. Patients were categorized into four groups (cognitively intact, dementia of the Alzheimer's type (DAT), other dementia, and patients with depressive symptoms). Patients were assessed for severity of dementia by the Clinical Dementia Rating scale. Differences between groups for various clinical parameters were evaluated using an analysis of variance and Duncan's Multiple Range Test. Patients with dementia, regardless of etiologic type or severity, and patients with depressive symptoms had BMI's greater than or equal to 10% lower than the cognitively intact patients. BMI was positively correlated with Instrumental Activities of Daily Living (IADL) but not Activities of Daily Living (ADL) or Mini-Mental State Exam (MMSE) score. Low BMI was not associated with increased physical illness. In fact, in the subset of patients with DAT, lower BMI correlated with significantly lesser amounts of comorbid physical illness. Finally, compared to cognitively intact outpatients, patients with DAT appeared to be physically healthier despite their having a lower BMI. These results suggest an association between dementia and low BMI. On the other hand, the presence of comorbid physical illness, a common focus of evaluation in these patients, was not more common in those patients with lower BMI's.

Relationship between body mass index and different domains of disability in older persons: the 3C study

“…Our findings on the relationship between obesity and BMI are in agreement with most of the recent studies conducted on BMI and ADL, [24][25][26] IADL, 25,27,19 incontinence, 20,21 mobility 22,23,[28][29][30] or limited physical functioning. [31][32][33][34] Obesity can be associated with functional limitations due to difficulties to perform certain movements and an increase of sedentariness 35 or through the occurrence of disabling pathologies.…”

“…Further analyses were therefore performed to adjust for potential confounding covariates. The OR and their 95% Confidence Intervals (CI) for disability in each domain are presented in Table 2 after adjustments for sociodemographic characteristics, the 'normal' BMI group [19][20][21][22][23] taken as the reference. For each area of disability considered, differences were observed according to sex in the strength of the association between disability and BMI, as well as in the nature of relationships.…”

“…The thresholds of BMI considered were those used in the Mini Nutritional Assessment for low BMI, 10 those recommended for defining overweight in elderly persons 11 and those recommended by the OMS for obesity: 12 o19, [19][20][21], [21][22][23], [23][24][25][26][27], [27][28][29][30], [30][31][32][33][34][35], and Z35. BMI was considered as a categorical variable since the risk of disability associated with BMI was not supposed to be linear.…”

Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

“…As malnutrition in elderly people is associated with impaired activity and general physical condition , a high prevalence of infections (Michael et al, 1991), increased risk of developing pressure sores , reduced mental capacity (Berlinger & Potter, 1991) and increased mortality rate (Larsson et al, 1990;Christensson et al, 1999), nutritional assessment can also be based on clinical criteria. In order to find a suitable tool for screening for nutritional problems in elderly people, two global assessment tools, the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment (MNA), have been tested.…”

Diagnosis, Classification and Natural History of Degenerative Dementias

“…99 A basal metabolic index (wt in kgs/height in m 2 ) of <20 was associated with a near significant increased risk to VaD, extending an observation from other studies. 100 The potential for treatment of hypertension to reduce the incidence of dementia has been suggested by the promising results of the SYST-EUR trial 1 0 1 where the incidence of dementia was halved treating with nitredine, a calcium channel blocker, supplemented with enalapril and a thiazide as required for BP control. Other studies have made contradictory findings.…”