The Relationship Between Dementia Subtypes and Nutritional Parameters in Older Adults

Soysal, Pınar; Dokuzlar, Özge; Erken, Neziha; Günay, Fatma Sena Dost; Işık, Ahmet Turan

doi:10.1016/j.jamda.2020.06.051

Cited by 32 publications

(28 citation statements)

References 31 publications

(39 reference statements)

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“…Another important point is that AChEIs prescribed for treatment of certain dementia subtypes can cause WL, which makes it more difficult to control WL in patients with dementia 13 . In our study, WL was more common in DLB than in AD or VD, partly consistent with a previous finding that malnutrition was more likely in DLB and VD compared to AD 8 ; this used a wider assessment of malnutrition via the Mini‐Nutritional Assessment‐Short Form (MNA‐SF) tool, 35 which in addition to WL also assesses food intake (including swallowing difficulties), mobility, neuropsychological problems and Body Mass Index. As swallowing and mobility difficulties might be more common in VD than in AD 36,37 this could explain the difference between the two studies.…”

Section: Discussionsupporting

confidence: 88%

“…In general populations of older people, WL is associated with higher rates of mortality, institutionalization, decline in functional status, worse quality of life, and frailty 4–7 . Although age is a risk factor for both cognitive impairment and WL, there is growing evidence that cognitive decline and nutritional deficiency are closely interrelated, regardless of ageing 8 . However, the relationship between dementia and WL is complex and people with dementia might be more prone to losing weight for several reasons.…”

Section: Introductionmentioning

confidence: 99%

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Weight loss in Alzheimer's disease, vascular dementia and dementia with Lewy bodies: Impact on mortality and hospitalization by dementia subtype

Soysal

Tan

Rogowska

et al. 2021

Int J Geriat Psychiatry

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Objectives Loss of weight is associated with cognitive decline as well as several adverse outcomes in dementia. The aim of this study was to assess whether weight loss is associated with mortality and hospitalization in dementia subtypes. Methods A cohort of 11,607 patients with dementia in Alzheimer's disease (AD), vascular dementia (VD), or dementia with Lewy bodies (DLB) was assembled from a large dementia care health records database in Southeast London. A natural language processing algorithm was developed to established whether loss of weight was recorded around the time of dementia diagnosis. Cox proportional hazard models were applied to examine the associations of reported weight loss with mortality and emergency hospitalization. Results Weight loss around the time of dementia was recorded in 25.5% of the whole sample and was most common in patients with DLB. A weight loss‐related increased risk for mortality was detected after adjustment for confounders (Hazard ratio (HR):1.07; 95% confidence interval (CI):1.02–1.15) and in patients with AD (HR: 1.11; 95% CI: 1.04–1.20), but not in DLB and VD. Weight loss was associated with a significantly increased emergency hospitalization risk (HR: 1.14; 95% CI: 1.08–1.20) and in all three subtypes. Conclusions While there were associations with increased hospitalization risk for all three subtype diagnoses, weight loss was only associated with increased mortality in AD. Weight loss should be considered as an accompanying symptom in dementia and interventions should be considered to ameliorate risk of adverse outcomes.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Weight loss in Alzheimer's disease, vascular dementia and dementia with Lewy bodies: Impact on mortality and hospitalization by dementia subtype

Soysal

Tan

Rogowska

et al. 2021

Int J Geriat Psychiatry

Self Cite

View full text Add to dashboard Cite

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“…Interventions in both nutrition and physical activity domains may produce additive benefits with regard to cognition (Klimova and Valis 2018). While dementia in general is associated with malnutrition, nutritional status may be worse in dementia with Lewy bodies and vascular dementia compared to other dementias (Soysal et al 2020). Malnutrition itself can trigger behavioral disturbances and other morbidities in patients with cognitive impairment.…”

Section: Nutrition Physical Activity and Cognitive Impairmentmentioning

confidence: 99%

Geriatric Nutritional Assessment and Treatment Frameworks

Dharmarajan

2021

Geriatric Gastroenterology

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Malnutrition is common in older adults in the community, nursing home, and hospital. Deficiencies in caloric and vitamin intake increase with age, functional impairment, and institutionalization, with resultant added risk of skin breakdown, illness, and death. Common contributory factors to undernutrition include polypharmacy, dementia, depression, oral health problems, and socioeconomic factors. Unintentional weight loss always warrants evaluation. Nutritional assessment includes a focused medical and social history, anthropometrics, selected biochemical andSince the original publication of the chapter in the first edition of Geriatric Gastroenterology (Springer), Kenneth Lloyd Minaker MD, co-author, has passed away; his contributions to the original chapter and the field of geriatrics have been invaluable

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“…In fact, adherence to proinflammatory dietary patterns was associated with greater cognitive decline [23,24], while dietary anti-inflammatory patterns reduce the inflammatory burden in periodontitis lesions [25]. Additionally, vitamin D deficiency has been growing attention reasonably in dementia [26][27][28] and periodontitis [29] since lower vitamin D intake associates with a higher risk of both conditions. However, the mediating role of inflammatory diet and vitamin D on the association of periodontal status and cognitive function has never been investigated.…”

Section: Introductionmentioning

confidence: 99%

The Role of Inflammatory Diet and Vitamin D on the Link between Periodontitis and Cognitive Function: A Mediation Analysis in Older Adults

et al. 2021

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Patients suffering from periodontitis are at a higher risk of developing cognitive dysfunction. However, the mediation effect of an inflammatory diet and serum vitamin D levels in this link is unclear. In total, 2062 participants aged 60 years or older with complete periodontal diagnosis and cognitive tests from the National Health and Nutrition Examination Survey (NHANES) 2011–2012 and 2013–2014 were enrolled. The Consortium to Establish a Registry for Alzheimer’s disease (CERAD) word learning subtest (WLT) and CERAD delayed recall test (DRT), the animal fluency test (AFT) and the digit symbol substitution test (DSST) was used. Dietary inflammatory index (DII) was computed via nutrition datasets. Mediation analysis tested the effects of DII and vitamin D levels in the association of mean probing depth (PD) and attachment loss (AL) in all four cognitive tests. Periodontitis patients obtained worse cognitive test scores than periodontally healthy individuals. DII was negatively associated with CERAD-WLT, CERAD-DRT, AFT and DSST, and was estimated to mediate between 9.2% and 36.4% of the total association between periodontitis with cognitive dysfunction (p < 0.05). Vitamin D showed a weak association between CERAD-DRT, AFT and DSST and was estimated to between 8.1% and 73.2% of the association between periodontitis and cognitive dysfunction (p < 0.05). The association between periodontitis and impaired cognitive function seems to be mediated both by a proinflammatory dietary load and vitamin D deficiency. Future studies should further explore these mediators in the periodontitis-cognitive decline link.

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The Relationship Between Dementia Subtypes and Nutritional Parameters in Older Adults

Cited by 32 publications

References 31 publications

Weight loss in Alzheimer's disease, vascular dementia and dementia with Lewy bodies: Impact on mortality and hospitalization by dementia subtype

Weight loss in Alzheimer's disease, vascular dementia and dementia with Lewy bodies: Impact on mortality and hospitalization by dementia subtype

Geriatric Nutritional Assessment and Treatment Frameworks

The Role of Inflammatory Diet and Vitamin D on the Link between Periodontitis and Cognitive Function: A Mediation Analysis in Older Adults

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