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Differences in Nutritional Status Between Very Mild Alzheimer's Disease Patients and Healthy Controls

Article type: Research Article

Authors: Olde Rikkert, Marcel G.M.a; 1; * | Verhey, Frans R.b | Sijben, John W.C.c | Bouwman, Femke H.d; 1 | Dautzenberg, Paul L.J.e | Lansink, Mirianc | Sipers, Walther M.W.f | van Asselt, Dieneke Z.B.g | van Hees, Anneke M.J.c | Stevens, Martijnh | Vellas, Brunoi | Scheltens, Philipj

Affiliations: [a] Radboud Alzheimer Center, Department of Geriatric Medicine, Radboud University Hospital, Nijmegen, The Netherlands | [b] Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands | [c] Nutricia Research, Utrecht, The Netherlands | [d] Neurology Department, Catharina Ziekenhuis, Eindhoven, The Netherlands | [e] Geriatrics Department, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, The Netherlands | [f] Department of Geriatric Medicine, Orbis Medisch Centrum, Sittard, The Netherlands | [g] Department of Geriatric Medicine, Medical Center Leeuwarden, Leeuwarden, The Netherlands | [h] Neurology Department, Tergooiziekenhuizen Blaricum, Blaricum, The Netherlands | [i] Gerontopole, INSERM U 1027, Toulouse, France | [j] Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands

Correspondence: [*] Correspondence to: Professor Marcel Olde Rikkert, MD, PhD, Radboud Alzheimer Center, Department of Geriatric Medicine, Radboud University Hospital, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 24 361 67 72; Fax: +31 24 361 74 08; E-mail: M.Olde-Rikkert@ger.umcn.nl.

Note: [1] Present address: Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands.

Keywords: Alzheimer's disease, fatty acids, healthy volunteers, micronutrients, nutritional status, protein-energy malnutrition

DOI: 10.3233/JAD-131892

Journal: Journal of Alzheimer's Disease, vol. 41, no. 1, pp. 261-271, 2014

Accepted 21 January 2014
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Published: 4 June 2014
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Abstract

Background:

Studies on the systemic availability of nutrients and nutritional status in Alzheimer’s disease (AD) are widely available, but the majority included patients in a moderate stage of AD.

Objective:

This study compares the nutritional status between mild AD outpatients and healthy controls.

Methods:

A subgroup of Dutch drug-naïve patients with mild AD (Mini-Mental State Examination (MMSE) ≥20) from the Souvenir II randomized controlled study (NTR1975) and a group of Dutch healthy controls were included. Nutritional status was assessed by measuring levels of several nutrients, conducting the Mini Nutritional Assessment (MNA®) questionnaire and through anthropometric measures.

Results:

In total, data of 93 healthy cognitively intact controls (MMSE 29.0 [23.0–30.0]) and 79 very mild AD patients (MMSE = 25.0 [20.0–30.0]) were included. Plasma selenium (p < 0.001) and uridine (p = 0.046) levels were significantly lower in AD patients, with a similar trend for plasma vitamin D (p = 0.094) levels. In addition, the fatty acid profile in erythrocyte membranes was different between groups for several fatty acids. Mean MNA screening score was significantly lower in AD patients (p = 0.008), but not indicative of malnutrition risk. No significant differences were observed for other micronutrient or anthropometric parameters.

Conclusion:

In non-malnourished patients with very mild AD, lower levels of some micronutrients, a different fatty acid profile in erythrocyte membranes and a slightly but significantly lower MNA screening score were observed. This suggests that subtle differences in nutrient status are present already in a very early stage of AD and in the absence of protein/energy malnutrition.

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