Malnutrition is Associated with Behavioral and Psychiatric Symptoms of Dementia in Older Women with Mild Cognitive Impairment and Early-Stage Alzheimer’s Disease

• Published in: Nutrients Vol. 11; no. 8; p. 1951
• Main Authors: Kimura, Ai, Sugimoto, Taiki, Kitamori, Kazuya, Saji, Naoki, Niida, Shumpei, Toba, Kenji, Sakurai, Takashi
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 20.08.2019; MDPI
• Subjects: Aged; Aged, 80 and over; aggression; Aging; Alzheimer disease; Alzheimer Disease - psychology; Alzheimer's disease; analysis of covariance; Apathy; at-risk population; Behavior; Body mass index; Caregivers; cognition; Cognition & reasoning; Cognitive ability; cognitive disorders; Cognitive Dysfunction - psychology; Dementia; Dementia - psychology; Disease prevention; elderly; Energy intake; factor analysis; Female; Geriatrics; Gerontology; Humans; Malnutrition; Malnutrition - complications; Malnutrition - epidemiology; Malnutrition - psychology; Marital status; Medical imaging; memory; Mortality; Nutrition Assessment; Nutritional Status; patients; Psychiatric Status Rating Scales; women; Japan; BPSD; dementia; nutritional status; mild cognitive impairment; Alzheimer’s disease
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11081951

We examined the nutritional status and its association with behavioral psychiatric symptoms of dementia (BPSD) among 741 memory clinic patients (normal cognition (NC), 152; mild cognitive impairment (MCI), 271; early-stage Alzheimer disease (AD), 318). Nutritional status and BPSD were assessed using the Mini Nutritional Assessment Short-Form (MNA-SF) and the Dementia Behavior Disturbance Scale (DBD), respectively. Compared to subjects with NC, more subjects with MCI and early-stage AD were at risk of malnutrition (MNA-SF, 8–11: NC, 34.2%; MCI, 47.5%; early-stage AD, 53.8%) and were malnourished (MNA-SF, 0–7: NC, 4.6%; MCI, 5.9%; early-stage AD, 8.2%). Among patients with MCI or early-stage AD, those at risk of/with malnutrition showed higher DBD scores than those well-nourished (12.7 ± 9.0 vs. 9.5 ± 7.3; p < 0.001). Moreover, analysis of covariance adjusting for confounders showed that nutritional status was significantly associated with specific BPSD, including “verbal aggressiveness/emotional disinhibition” (F = 5.87, p = 0.016) and “apathy/memory impairment” (F = 15.38, p < 0.001), which were revealed by factor analysis of DBD. Our results suggest that malnutrition is common among older adults with mild cognitive decline, and possibility that nutritional problems are associated with individual BPSD.