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Nutritional Status is Associated With Severe Dementia and Mortality

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Studies have reported faster cognitive/functional decline in persons with dementia (PWD) with malnutrition. We investigated whether baseline nutritional status predicted severe dementia and mortality in a population-based sample.


A maximum of 300 PWD were assessed annually for up to 8.6 years.


Nutritional status was assessed using a modified Mini-Nutritional Assessment (mMNA). Severe dementia was defined as: “severe” rating on the Clinical Dementia Rating or Mini-Mental State Examination score ≤10. Using Cox proportional hazards models, we examined the association between baseline mMNA score (or its subcomponents) with each outcome. Covariates included demographics; dementia onset age, type, and duration; APOE genotype; and residency with caregiver.


Compared with “well-nourished,” “malnourished” PWD had 3-4 times the hazard of severe dementia [hazard ratio (HR), 4.31; P=0.014] and death (HR, 3.04; P<0.001). Those “at risk for malnutrition” had twice the hazard of severe dementia (HR, 1.98; P=0.064) and 1.5 times the hazard of death (HR, 1.46; P=0.015). mMNA subcomponents of food group intake, weight loss, body mass index, mobility, health status, protein consumption, and mid-arm circumference predicted one or both outcomes.


Nutritional status is an important predictor of clinical outcomes in dementia and may provide an avenue for intervention.
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Keywords: Alzheimer disease; dementia; malnutrition; mortality; severe dementia

Document Type: Research Article

Affiliations: 1: Utah State University, Logan, UT 2: The Johns Hopkins University, Baltimore, MD

Publication date: October 1, 2018

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