Mild Hypothermia in Patients with Senile Dementia

• Published in: Nihon Rōnen Igakkai zasshi Vol. 29; no. 1; pp. 47 - 53
• Main Authors: Hazama, Sakae, Takahata, Tatsuo, Kaneshiro, Eizo, Kadoya, Yoshiki, Tagami, Seisaburo
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japan Geriatrics Society 01.01.1992
• Subjects: accidental hypothermia; Aged; Aged, 80 and over; Body Temperature; Dementia - complications; Dementia - physiopathology; Female; grade of dementia; Humans; Hypothermia - etiology; Male; Middle Aged; mild hypothermia; nutritional factors; Nutritional Status; senile dementia
• ISSN: 0300-9173
• DOI: 10.3143/geriatrics.29.47

From the viewpoint of the high frequency of mild hypothermia in patients with senile dementia, we investigated causative factors in comparison with accidental hypothermia. We also investigated the relationship between hypothermia and the type or grade of dementia. A total of 127 demented cases including 30males and 97 females, whose mean age was 80.6±8.9 years, were classified into 3 groups according to the axillar temperature measured in August 1989. Group A consisted of 33 cases whose body temperature was below 36°C on more than 25 days. Group C consisted of 24 cases whose body temperature was above 36°C on more than 25 days, and the remaining 70 cases were classified as group B. The frequency of group A classification in demented patients was higher than age-matched non-demented controls (26% vs 13%, p<0.05). In demented males, serum total cholesterol, serum albumin, and hemoglobin were significantly higher in group A than in group B or C. Body weight and serum triglyceride were also higher in group A, but not significantly. In demented females, serum albumin and hemoglobin were higher in groups A and B than group C. In addition, cases with diabetes mellitus or cases receiving with major tranquilizers were more frequent in group A, and the index of activities of daily living was higher in group A, in both sexes. Factors such as age, CRP or thyroid hormone (free T3, free T4) showed no significant difference among the 3 groups. In addition, there was no difference in the frequency of group A between degenerative dementia and vascular dementia, though Hachinski's ischemic score was higher in group C. Groups A and B had higher Mini-Mental State scores than group C, and the degree of brain atrophy calculated from CT was less in groups A and B than group C. The prognosis observed during 9 months showed higher mortality rate in group C than group A or B. These findings revealed that demented patients with mild hypothermia were in a better nutritional state and had better daily activity levels and prognoses. This fact suggests that mild hypothermia of demented patients had different pathophysiological aspects from accidental hypothermia. On the other hand, it was shown that patients with mild hypothermia seemed to have less advanced dementia. The possibility was discussed that body temperature in senile dementia may be affected not only by a nutritional state but also by other factors, including neurotransmitters in the brain.