Malnutrition And Cognitive Function Levels In Patients With Alzheimer's Disease Relevant Clinical Research

Objective:To screen the nutritional status of patients with Alzheimer's Disease(AD),to understand the incidence of malnutrition in AD patients,to analyze the influencing factors of malnutrition,and to explore the relationship between malnutrition and cognitive function levels in AD patients.Method:Subjects:80 patients diagnosed as AD in the Department of Geriatric Neurology,the First Affiliated Hospital of Nanjing Medical University from February 2016 to February 2018 were selected as the case group,including 42 males and 38 females with an average age of 80.11±8.14(years old),all in accordance with the standards for the diagnosis and statistical work of mental disorders(DSM-III/R,DSM-IV/TR).All participants and their families gave informed consent,excluding the history of radiotherapy and chemotherapy trauma,acute stress disorde in recent three months,swallowing and eating difficulties,and gastrointestinal diseases affecting digestion and absorption,and severe heart,liver and kidney dysfunction,and tumors End-stage patient.At the same time,60 cases of healthy elderly with no significant difference in age,gender and education level were selected as the normal control group,including33 males and 27 females with an average age of 78.86±7.26(years old).Methods:All the selected subjects'age,gender,height,weight,body mass index,education level,blood pressure and other general data were collected.The Short-Form Mini-Nutritional Assessment(MNA-SF)was used to evaluate the nutritional status of all enrollees.According to MNA-SF,AD patients were divided into malnutrition group and normal nutrition group.The cognitive function of AD patients was evaluated by Mini-Mental State Examination(MMSE).According to MMSE,they were divided into mild,moderate and severe dementia groups.The daily living ability scale(ADL)scores of AD patients were collected,as well as hemoglobin,total protein,albumin,urea nitrogen,serum creatinine,total cholesterol,triglycerides,and low-density lipoprotein-cholesterol,high-density lipoprotein-cholesterol,blood homocysteine,fasting blood glucose,glycosylated hemoglobin,and thyroid function collected in the fasting veins on the next morning.Statistical analysis:The?~2 test was used to analyze whether there was a difference in the incidence of malnutrition between AD patients and normal elderly people.Through t test,whether the factors such as age between AD malnutrition group and normal nutrition group were different.Pearson correlation analysis was used to investigate whether the nutritional levels of patients with different degrees of dementia were related to MMSE.Result:There were no significant difference in age,gender and education level between the 80 AD patients and 60 normal elderly people(P>0.05,see Table 1).There were48 cases(60%)of malnourished patients with AD,and 19 cases(31.67%)of malnourished people in normal elderly.There was a statistically significant difference in the incidence of malnutrition between the two groups by?2 test(?2=11.030,P<0.05,see Table 2).The MNA-SF of the AD group was 9.45±2.48,and the MNA-SF of the normal group was 11.28±2.11.The difference in nutritional levels between the two groups was statistically significant(t=4.510,P<0.05,see Table 2).The malnutrition group of AD patients compared with the normal nutrition group of AD patients,the two groups of patients with urea nitrogen,serum creatinine,total cholesterol,triglycerides,low-densitylipoprotein-cholesterol,high-density lipoprotein-cholesterol,blood homocysteine,fasting blood glucose,glycosylated hemoglobin,thyrotropy,systolic blood pressure,diastolic blood pressure and heart ratewas was no significant difference(P>0.05).The age,weight,BMI,cognitive function,daily activity,total protein,serum albumin and hemoglobin in the AD malnutrition group were significantly different from those in the AD normal nutrition group(P<0.05,see Table 3).The degree of dementia in AD patients was graded.The MNA-SF values of the mild,moderate,and severe groups were 10.93±1.67,9.32±1.84,and 7.38±3.01,respectively.The moderate to severe grades were lower than mild,and the severity was lower than moderate,statistical significance(F=17.536,P<0.05,see Table 4).The correlation between MNA-SF and MMSE in AD patients,MNA-SF was positively correlated with MMSE(r=0.61,P<0.05,see Figure 1).Conclusion:1.The incidence of malnutrition in patients with AD is high.2.MMSE score,ADL score,age,body weight,BMI,total protein,serum albumin,and hemoglobin are influencing factors for malnutrition in AD patients.3.The nutritional level of AD patients was positively correlated with the MMSE score,that is,the lower the nutritional level,the lower the cognitive function score.4.For elderly patients with malnutrition,routine evaluation of cognitive function is needed in order to detect mild cognitive dysfunction and dementia early,early treatment;routine assessment of nutritional status in elderly people with cognitive impairment,timely detection of malnutrition(nutrition Adverse risk)and intervention to prevent or delay the development of AD.