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Review
. 2019 Apr;10(2):263-277.
doi: 10.1002/jcsm.12380. Epub 2019 Feb 22.

Cachexia and advanced dementia

Cecilia Minaglia  1 , Chiara Giannotti  1 , Virginia Boccardi  2 , Patrizia Mecocci  2 , Gianluca Serafini  3   4 , Patrizio Odetti  1   5 , Fiammetta Monacelli  1   5
Affiliations
Review

Cachexia and advanced dementia

Cecilia Minaglia et al. J Cachexia Sarcopenia Muscle. 2019 Apr.

Abstract

Cachexia is a complex metabolic process that is associated with several end-stage organ diseases. It is known to be also associated with advanced dementia, although the pathophysiologic mechanisms are still largely unknown. The present narrative review is aimed at presenting recent insights concerning the pathophysiology of weight loss and wasting syndrome in dementia, the putative mechanisms involved in the dysregulation of energy balance, and the interplay among the chronic clinical conditions of sarcopenia, malnutrition, and frailty in the elderly. We discuss the clinical implications of these new insights, with particular attention to the challenging question of nutritional needs in advanced dementia and the utility of tube feeding in order to optimize the management of end-stage dementia.

Keywords: Advanced dementia; Cachexia; Failure to thrive; Frailty; Sarcopenia; Supportive care.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
The interplay between anorexia/malnutrition, sarcopenia, cachexia, and dementia. AGEs, advanced glycation end products; IL, interleukin; TNF‐alpha, tumour necrosis factor alpha.
See this image and copyright information in PMC

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