营养不良、认知能力下降和痴呆症:PROMED-COG 联合队列协作研究

IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Clinical nutrition Pub Date : 2024-09-10 DOI:10.1016/j.clnu.2024.09.001
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引用次数: 0

摘要

背景& 目的营养不良可能会对认知功能产生负面影响,但这种关系的证据尚未得到巩固。在 "PROtein富含地中海膳食,消除营养不良,促进神经健康老龄化"(PROMED-COG)项目中,我们评估了营养不良与老年人认知能力下降和痴呆症之间的关系。方法对三项基于意大利人口的研究进行了回顾性数据协调:意大利老龄化纵向研究(ILSA)、Progetto Veneto Anziani(Pro.V.A.)和Bollate Eye Study-Follow-Up(BEST-FU)。通过 Cox 比例危险回归模型评估了营养不良(采用全球营养不良领导倡议(GLIM)标准进行操作)与迷你精神状态检查(MMSE)下降或痴呆症发病率随访之间的关系。基线营养不良发生率为 14.3%,女性(15.4% 对 13%)和老年人显著较高,从 60 岁人群的 3.5% 到 85 岁以上人群的 28.8%。营养不良与中位随访8.3年的认知能力下降(危险比(HR)1.20,95%置信区间(CI)1.02-1.41,p = 0.028)和中位随访8.6年的痴呆症发病率(HR = 1.57,95%CI 1.01-2.43,p = 0.046)有关。就认知能力下降而言,男性与营养不良的关系比女性更为明显(HR = 1.36,95%CI 1.05-1.77,p = 0.019 vs HR = 1.10,95%CI 0.89-1.36,p = 0.375)。预防和早期识别营养不良可能是应对神经退行性病变的重要非药物策略。
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Undernutrition, cognitive decline and dementia: The collaborative PROMED-COG pooled cohorts study

Background & aims

Undernutrition may negatively impact cognitive function, but evidence of this relationship is not yet consolidated. Under the “PROtein enriched MEDiterranean diet to combat undernutrition and promote healthy neuroCOGnitive ageing” (PROMED-COG) project, we evaluated the association between undernutrition, and cognitive decline and incident dementia in older adults.

Methods

Retrospective data harmonization was performed on three Italian population-based studies: the Italian Longitudinal Study of Ageing (ILSA), the Progetto Veneto Anziani (Pro.V.A.), and the Bollate Eye Study-Follow-Up (BEST-FU). The associations between undernutrition, operationalized using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and decline on the Mini-Mental State Examination (MMSE) or dementia incidence follow-up were evaluated with Cox proportional hazard regression models.

Results

The pooled cohort comprised 9071 individuals (52% females) aged between 42 and 101 years. The prevalence of undernutrition at the baseline was 14.3%, significantly higher among females (15.4% vs 13%) and in older age, ranging from 3.5% in those aged <60 years to 28.8% in those 85+ years. Undernutrition was associated with both cognitive decline over a median 8.3-year follow-up (Hazard Ratio (HR) 1.20, 95% Confidence Interval (CI) 1.02–1.41, p = 0.028) and incidence of dementia over a median 8.6-year follow-up (HR = 1.57, 95%CI 1.01–2.43, p = 0.046). For cognitive decline, the association with undernutrition was more marked in males than females (HR = 1.36, 95%CI 1.05–1.77, p = 0.019 vs HR = 1.10, 95% CI 0.89–1.36, p = 0.375).

Conclusion

Undernutrition is prevalent among older people and is associated with an increased risk of experiencing cognitive decline and dementia. The prevention and early identification of undernutrition could be an important nonpharmacologic strategy to counteract neurodegeneration.

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来源期刊
Clinical nutrition
Clinical nutrition 医学-营养学
CiteScore
14.10
自引率
6.30%
发文量
356
审稿时长
28 days
期刊介绍: Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.
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