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. 2020 Aug 11;12(1):e12063.
doi: 10.1002/dad2.12063. eCollection 2020.

Nutritional status and structural brain changes in Alzheimer's disease: The NUDAD project

Barbara J H Verhaar  1   2 , Francisca A de Leeuw  1   3 , Astrid S Doorduijn  1   4 , Jay L P Fieldhouse  1 , Ondine van de Rest  5 , Charlotte E Teunissen  3 , Bart N M van Berckel  6 , Frederik Barkhof  1   6   7 , Marjolein Visser  8 , Marian A E de van der Schueren  4   9 , Philip Scheltens  1 , Maartje I Kester  1 , Majon Muller  2 , Wiesje M van der Flier  1
Affiliations

Nutritional status and structural brain changes in Alzheimer's disease: The NUDAD project

Barbara J H Verhaar et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Weight loss is associated with higher mortality and progression of cognitive decline, but its associations with magnetic resonance imaging (MRI) changes related to Alzheimer's disease (AD) are unknown.

Methods: We included 412 patients from the NUDAD project, comprising 129 with AD dementia, 107 with mild cognitive impairment (MCI), and 176 controls. Associations between nutritional status and MRI measures were analyzed using linear regression, adjusted for age, sex, education, cognitive functioning, and cardiovascular risk factors.

Results: Lower body mass index (BMI), fat mass (FM), and fat free mass index were associated with higher medial temporal atrophy (MTA) scores. Lower BMI, FM, and waist circumference were associated with more microbleeds. Stratification by diagnosis showed that the observed associations with microbleeds were only significant in MCI.

Discussion: Lower indicators of nutritional status were associated with more MTA and microbleeds, with largest effect sizes in MCI.

Keywords: body mass index; cerebral atrophy; fat free mass; fat mass; magnetic resonance imaging; malnutrition; microbleeds; mild cognitive impairment; nutritional status; white matter hyperintensities.

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Conflict of interest statement

Charlotte E. Teunissen received grants from the European Commission, the Dutch Research Council (ZonMW), Association of Frontotemporal Dementia/Alzheimer's Drug Discovery Foundation, The Weston Brain Institute, Alzheimer Netherlands. Charlotte E. Teunissen has a collaboration contract with ADx Neurosciences, performed contract research or received grants from Probiodrug, Biogen, Esai, Toyama, Janssen prevention center, Boehringer, AxonNeurosciences, Fujirebio, EIP farma, PeopleBio, and Roche. Bart NM van Berckel received research support from ZonMW, AVID radiopharmaceuticals, CTMM, and Janssen Pharmaceuticals. He is a trainer for Piramal and GE. He receives no personal honoraria. Frederik Barkhof is a consultant for Biogen‐Idec, Janssen Alzheimer Immunotherapy, Bayer‐Schering, Merck‐Serono, Roche, Novartis, Genzyme, and Sanofi‐Aventis; has received sponsorship from European Commission–Horizon 2020, National Institute for Health Research–University College London Hospitals Biomedical Research Centre, Scottish Multiple Sclerosis Register, TEVA, Novartis, and Toshiba; and serves on the editorial boards of Radiology, Brain, Neuroradiology, Multiple Sclerosis Journal, and Neurology. Philip Scheltens has received consultancy/speaker fees from Lilly, GE Healthcare, Novartis, Sanofi, Nutricia, Probiodrug, Biogen, Roche, Avraham, and EIP Pharma. PS has acquired grant support from GE Healthcare, Danone Research, Piramal, and MERCK. All funding was paid to the institution. Wiesje M van der Flier received grants from ZonMW, the Food cognition and behavior program of The Dutch Research Council (NWO‐FCB), The EU Joint Programme–Neurodegenerative Disease Research (EU‐JPND), Alzheimer Nederland, Health‐Holland, Topsector Life Sciences & Health, Biogen MA Inc, Boehringer Ingelheim, Life Molecular Imaging, AVID Radiopharmaceuticals, Roche BV, Combinostics, Janssen Stellar, Gieskes Strijbis fonds, and Stichting Equilibrio. Wiesje M van der Flier has performed contract research for Biogen MA Inc and Boehringer Ingelheim and has been an invited speaker at Boehringer Ingelheim and Biogen MA Inc. All funding was paid to the institution. Barbara JH Verhaar, Francisca A de Leeuw, Astrid S Doorduijn, Jay LP Fieldhouse, Ondine van de Rest, Marjolein Visser, Marian AE de van der Schueren, Maartje I Kester, and Majon Muller report no disclosures.

Figures

FIGURE 1
FIGURE 1
Associations stratified for diagnosis. Forest plots with associations between nutritional parameters and magnetic resonance imaging markers stratified for diagnosis, presented as standardized betas with confidence intervals. BMI, body mass index; FFMI, fat free mass index; FM, fat mass; GCA, global cortical atrophy; GCA, global cortical atrophy; MNA, Mini Nutritional Assessment; MTA, medial temporal atrophy; WMH, white matter hyperintensities
FIGURE 2
FIGURE 2
Associations stratified for diagnosis in amyloid positive patients. Forest plots with associations between nutritional parameters and magnetic resonance imaging markers in amyloid positive patients (N = 187), stratified for diagnosis, presented as standardized betas with confidence intervals. BMI, body mass index; FFMI, fat free mass index; FM, fat mass; GCA, global cortical atrophy; MNA, Mini Nutritional Assessment; MTA, medial temporal atrophy; WMH, white matter hyperintensities
See this image and copyright information in PMC

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