Malnutrition in Alzheimer’s Disease, Dementia with Lewy Bodies, and Frontotemporal Lobar Degeneration: Comparison Using Serum Albumin, Total Protein, and Hemoglobin Level

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Abstract

Malnutrition among dementia patients is an important issue. However, the biochemical markers of malnutrition have not been well studied in this population. The purpose of this study was to compare biochemical blood markers among patients with Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), and frontotemporal lobar degeneration (FTLD). A total of 339 dementia outpatients and their family caregivers participated in this study. Low serum albumin was 7.2 times more prevalent among patients with DLB and 10.1 times more prevalent among those with FTLD than among those with AD, with adjustment for age. Low hemoglobin was 9.1 times more common in female DLB patients than in female AD patients, with adjustment for age. The levels of biochemical markers were not significantly correlated with cognitive function. Family caregivers of patients with low total protein, low albumin, or low hemoglobin were asked if the patients had loss of weight or appetite; 96.4% reported no loss of weight or appetite. In conclusion, nutritional status was worse in patients with DLB and FTLD than in those with AD. A multidimensional approach, including blood testing, is needed to assess malnutrition in patients with dementia.

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Association of kidney function with anemia: the Third National Health and Nutrition Examination Survey (1988-1994).

Adeera Levin, Brad C. Astor, Josef Coresh … (2002)

Kidney failure is known to cause anemia, which is associated with a higher risk of cardiac failure and mortality. The impact of milder decreases in kidney function on hemoglobin levels and anemia in the US population, however, is unknown. We analyzed a population-based sample of 15419 participants 20 years and older in the Third National Health and Nutrition Examination Survey, conducted from 1988 to 1994. Lower kidney function was associated with a lower hemoglobin level and a higher prevalence and severity of anemia below, but not above, an estimated glomerular filtration rate (GFR) of 60 mL/min per 1.73 m(2). Adjusted to the age of 60 years, the predicted median hemoglobin level among men (women) decreased from 14.9 (13.5) g/dL at an estimated GFR of 60 mL/min per 1.73 m(2) to 13.8 (12.2) g/dL at an estimated GFR of 30 mL/min per 1.73 m(2) and to 12.0 (10.3) g/dL at an estimated GFR of 15 mL/min per 1.73 m(2). The prevalence of anemia (hemoglobin level <12 g/dL in men and <11 g/dL in women) increased from 1% (95% confidence interval, 0.7%-2%) at an estimated GFR of 60 mL/min per 1.73 m(2) to 9% (95% confidence interval, 4%-19%) at an estimated GFR of 30 mL/min per 1.73 m(2) and to 33% (95% confidence interval, 11%-67%) at an estimated GFR of 15 mL/min per 1.73 m(2) among men and to 67% (95% confidence interval, 30%-90%) at an estimated GFR of 15 mL/min per 1.73 m(2) among women. An estimated GFR of 15 to 60 mL/min per 1.73 m(2) was present in 4% of the entire population and in 17% of the individuals with anemia. Below an estimated GFR of 60 mL/min per 1.73 m(2), lower kidney function is strongly associated with a higher prevalence of anemia among the US adult population.

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Evaluation and management of oropharyngeal dysphagia in different types of dementia: a systematic review.

Kannayiram Alagiakrishnan, Rahima A Bhanji, Mini Kurian (2013)

Dysphagia, or swallowing impairment, is a growing concern in dementia and can lead to malnutrition, dehydration, weight loss, functional decline, and fear of eating and drinking as well as a decrease in quality of life (QOL).

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Relationship between Eating Disturbance and Dementia Severity in Patients with Alzheimer’s Disease

Kyoko Kai, Mamoru Hashimoto, Koichiro Amano … (2015)

Background Eating is one of the most important daily activities in managing patients with dementia. Although various eating disturbance occur as dementia progresses, to our knowledge, most of the studies focused on a part of eating disturbance such as swallowing and appetite. There have been few comprehensive studies including eating habits and food preference in patients with Alzheimer’s disease (AD). The aims of this study were to investigate almost all eating disturbance and to examine the relationship of eating disturbance to dementia stage in AD. Methods A total of 220 patients with AD and 30 normal elderly (NE) subjects were recruited. Eating disturbance was assessed by a comprehensive questionnaire that had been previously validated. Potential relationships between the characteristics of eating disturbance and dementia stage as classified by the Clinical Dementia Rating (CDR) were assessed. Results Overall, 81.4% of patients with AD showed some eating and swallowing disturbance, whereas only 26.7% of the NE subjects had such a disturbance. Even in an early stage, patients with AD had many types of eating disturbance; “Appetite change” was shown in nearly half of the mild AD patients (49.5%). In the moderate stage, the scores of “change of eating habits and food preference” were highest, and in the severe stage “swallowing disturbance” became critical. Conclusion In AD, the relationship of dementia stage to eating disturbance differs according to the type of eating disturbance. The relationships between various eating disturbance and the severity of dementia should be considered.

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Lisa Chakrabarti: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 23 June 2016

Publication date Collection: 2016

Volume: 11

Issue: 6

Electronic Location Identifier: e0157053

Affiliations

[1 ]Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

[2 ]Faculty of Human Life Science, Shokei University, Kumamoto, Japan

University of Nottingham, UNITED KINGDOM

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: AK MH HT NF MM YM YH RF NH ST KM MK MI. Performed the experiments: AK MM. Analyzed the data: AK MH MM. Wrote the paper: AK MH MI.

* E-mail: asuka@ 123456fc.kuh.kumamoto-u.ac.jp

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Asuka Koyama http://orcid.org/0000-0002-4559-1460

Article

Publisher ID: PONE-D-16-06113

DOI: 10.1371/journal.pone.0157053

PMC ID: 4919003

PubMed ID: 27336725

SO-VID: d5234eb8-c4d0-48d4-a832-bac446542ecf

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This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Date received : 12 February 2016

Date accepted : 24 May 2016

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Figures: 0, Tables: 3, Pages: 7

Funding

Funded by: funder-id http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;

Award ID: 26780306

Award Recipient :

ORCID: http://orcid.org/0000-0002-4559-1460

Asuka Koyama

This study was supported by a grant provided by Japan Society for the Promotion of Science (JSPS) Grants-in-Aid for Scientific Research (KAKENHI) Grant Number 26780306 (Grant-in-Aid for Young Scientists (B)), http://www.jsps.go.jp/english/e-grants/index.html. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Data Availability Due to identifying patient information, data is available upon request to Asuka Koyama at asuka@ 123456fc.kuh.kumamoto-u.ac.jp .

Malnutrition in Alzheimer’s Disease, Dementia with Lewy Bodies, and Frontotemporal Lobar Degeneration: Comparison Using Serum Albumin, Total Protein, and Hemoglobin Level

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Most cited references 10

Association of kidney function with anemia: the Third National Health and Nutrition Examination Survey (1988-1994).

Evaluation and management of oropharyngeal dysphagia in different types of dementia: a systematic review.

Relationship between Eating Disturbance and Dementia Severity in Patients with Alzheimer’s Disease

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