Possible Predictors of Involuntary Weight Loss in Patients with Alzheimer's Disease

PLoS One. 2016 Jun 27;11(6):e0157384. doi: 10.1371/journal.pone.0157384. eCollection 2016.

Abstract

Loss in body mass (∆BM) is a common feature in patients with Alzheimer's disease (AD). However, the etiology of this phenomenon is unclear. The aim of this cohort study was to observe possible ∆BM in AD patients following a standard institutionalized diet. Secondary objective was to identify possible predictors of ∆BM. To this end, 85 AD patients (age: 76±4 yrs; stature: 165±3 cm; BM: 61.6±7.4 kg; mean±standard deviation) and 86 controls (CTRL; age: 78±5 yrs; stature: 166±4 cm; BM: 61.7±6.4 kg) were followed during one year of standard institutionalized diet (~1800 kcal/24h). BM, daily energy expenditure, albuminemia, number of medications taken, and cortisolism, were recorded PRE and POST the observation period. Potential predictors of ∆BM in women (W) and men (M) with AD were calculated with a forward stepwise regression model. After one year of standard institutionalized diet, BM decreased significantly in AD (-2.5 kg; p < 0.01), while in CTRL remained unchanged (-0.4 kg; p = 0.8). AD patients and CTRL exhibited similar levels of daily energy expenditure (~1625 kcal/24h). The combination of three factors, number of medications taken, albuminemia, and cortisolism, predicted ∆BM in W with AD. At contrary, the best predictor of ∆BM in M with AD was the cortisolism. Despite a controlled energy intake and similar energy expenditure, both W and M with AD suffered of ∆BM. Therefore, controlled diet did not prevent this phenomenon. The assessments of these variables may predict W and M with AD at risk of weight loss.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / blood
  • Alzheimer Disease / complications*
  • Alzheimer Disease / metabolism
  • Alzheimer Disease / pathology
  • Biomarkers / blood
  • Case-Control Studies
  • Diet
  • Energy Metabolism*
  • Female
  • Humans
  • Hydrocortisone / blood
  • Male
  • Serum Albumin / analysis
  • Weight Loss*

Substances

  • Biomarkers
  • Serum Albumin
  • Hydrocortisone

Grants and funding

The study was supported by grant #15-6-3016000-115 accorded to MV by the Department of Biomedical Sciences for Health, University of Milan, by the grant #KL2Y73_004 from the Italian Ministry for Research (PRIN 2010), accorded to FS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.