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. 2018 Jul 6:6:e5150.
doi: 10.7717/peerj.5150. eCollection 2018.

Study of community-living Alzheimer's patients' adherence to the Mediterranean diet and risks of malnutrition at different disease stages

Mariona Rocaspana-García  1 , Joan Blanco-Blanco  2 , Alfonso Arias-Pastor  3 , Montserrat Gea-Sánchez  2 , Gerard Piñol-Ripoll  3
Affiliations

Study of community-living Alzheimer's patients' adherence to the Mediterranean diet and risks of malnutrition at different disease stages

Mariona Rocaspana-García et al. PeerJ. .

Abstract

Background: Alzheimer's disease (AD) is a neurodegenerative disease that is characterized by deficits in episodic memory. It is the most common form of dementia and affects 50-70% of patients with cognitive impairments over the age of 65. Elderly people are particularly susceptible to malnutrition and that risk is even higher in patients with AD. This study assessed the nutritional status of patients with AD at different stages of AD and explored how that status correlated with cognitive, functional and behavioural variables and caregiver overburden. The characteristics of the diet and the degree of adherence to the Mediterranean diet were also analysed.

Methods: This was a cross-sectional study that was representative of the general population and it was carried out in the Unit of Cognitive Disorders, Lleida, Spain. The participants were 111 subjects with AD who were aged 65 and over and still living at home. The subjects' nutritional status was assessed using the Mini Nutritional Assessment (MNA) and Controlling Nutritional Status system. The monthly food intake was estimated using the short Food Frequency Questionnaire and adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Score. The Mini Mental State Examination (MMSE), Global Deterioration Scale, Neuropsychiatric Inventory (NPI) and Zarit Burden Interview (ZBI) were also used.

Results: We found that 68% of the subjects presented with a risk of malnutrition and 19% were malnourished according to the MNA scale. Patients ate a higher quantity of meat and dairy products than recommended and fewer products from the remaining healthier food groups. Of the 111 subjects, 73% showed low adherence to the Mediterranean diet and 27% showed moderate adherence. There was a partial correlation between nutritional status and the MMSE when the data were adjusted for age and sex (r = 0, 318; p = 0.001) and inverse correlations were found for functional status (r = - 0.283; p = 0.004) and the NPI (r = - 0.409; p = 0.000) and ZBI scales (r = - 0.433; p = 0.000) when they were adjusted using the same variables. The ZBI scale (OR 1.08, 95% CI [1.01-1.15]) showed an increase in the risk of malnutrition in the multivariate analysis.

Discussion: Alterations in nutritional status were more common during the advanced stages of AD and were also associated with behavioural changes and caregiver overburden. Low adherence to traditional healthy diets in Mediterranean countries and food intake profiles should be considered when managing patients with AD. Other countries can use the results to examine diets in people with AD that are high in meat and dairy and low in healthy food groups like fruit and vegetables.

Keywords: Alzheimer’s disease; Cognition; Mediterranian diet; Nutrition Assessment; Nutritional Status.

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Conflict of interest statement

The authors declare there are no competing interests.

References

    1. Abellán J, Zafrilla MP, Montoro S, Mulero J, Pérez A, Leal M, Guerrero L, Ramos E, Ruilope LM. Adherence to the ¡¡Mediterranean Diet¿¿ in Spain and its relationship with cardiovascular risk (DIMERICA study) Nutrients. 2016;8(11) doi: 10.3390/nu8110680. Article 680. - DOI - PMC - PubMed
    1. Andrieu S, Reynish W, Nourhashemi F, Ousset PJ, Grandjean H, Grand A, Albarede JL, Vellas B. Nutritional risk factors for institutional placement in Alzheimer’s disease after one year follow-up. The Journal of Nutrition, Health & Aging. 2001;5(2):113–117. - PubMed
    1. Beydoun MA, Beydoun HA, Wang Y. Obesity and central obesity as risk factors for incident dementia and its subtypes: a systematic review and meta-analysis. Obesity Reviews. 2008;9:204–218. doi: 10.1111/j.1467-789X.2008.00473.x. - DOI - PMC - PubMed
    1. Botella JJ, Ferrero I. La alimentación del enfermo de Alzheimer en el ámbito familiar. Nutrición Hospitalaria. 2004;19(3):154–159. - PubMed
    1. Candeias E, Duarte A, Sebastião I, Fernandes M, Plácido AI, Carvalho C, Correia S, Santos RX, Seiça R, Santos MS, Oliveira CR, Moreira PI. Middle-aged diabetic females and males present distinct susceptibility to Alzheimer disease-like pathology. Molecular Neurobiology. 2017;54(8):6471–6489. doi: 10.1007/s12035-016-0155-1. - DOI - PubMed

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