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Weight Loss Begins Before Symptoms of Dementia
Become Obvious
Weight loss common in Alzheimer's
Jan. 11, 2005 Weight loss associated with
dementia begins before the symptoms of dementia are seen sometimes
years before - and accelerates by the time of the diagnosis, according
to a study in the January issue of Archives of Neurology, one of
the JAMA/Archives journals.
Weight loss in old age is common and may be related
to various diseases, according to background information in the article.
It has long been observed that weight loss is common in Alzheimer's
disease (AD), but this has been documented in people who already have
dementia.
Robert Stewart, M.D., From the Institute of
Psychiatry, London, and colleagues analyzed data from 1,890 men (aged
77-98 years) who were participants in The Honolulu-Asia Aging Study.
This population-based study of Japanese American men included 112 men
with incident [new onset] dementia and 1,778 without dementia. The study
participants were examined on six occasions over a period of up to 34
years. Weight was measured at each examination and dementia was
ascertained at the three most recent examinations.
Incident dementia was associated with significant
previous weight loss, which was independent of a large number of
potential confounding factors, the researchers found.
A high proportion of men with dementia at
examination 6 had lost at least about 11 pounds, which approaches 10
percent of average body weight for this cohort. This weight loss
occurred in many cases over the two to four years prior to reaching the
clinical threshold of dementia. The association was similar in AD and
vascular dementia.
"In conclusion the important consideration arising from research in this
area is the extent to which weight loss may be prevented or minimized in
dementia. Poor nutrition and frailty frequently complicate later stages
of dementia, causing falls, poor wound healing, and increased physical
dependence.
"The
results presented here suggest that weight change and nutritional state
in people with dementia should be taken seriously at least from the time
of diagnosis if not at earlier stages of more mild cognitive
impairment.
Editors Note: Dr. Stewart was supported by a
Research Training Fellowship in Clinical Epidemiology from the Wellcome
Trust, London, United Kingdom. The Honolulu-Asia Aging Study is
supported by the National Institutes of Health, Bethesda, Md.:
National Institute on Aging and National Heart, Lung, and Blood
Institute.
Editorial: Weight Loss in the Elderly May Be a Sign
of Impending Dementia
In an accompanying editorial, Michael Grundman, M.D., M.P.H., from Elan
Pharmaceuticals, San Diego, Calif., writes: The article by Stewart et
al in this issue of Archives of Neurology provide evidence that men who
develop dementia (both AD and vascular dementia) tend to start losing
weight at least several years prior to their clinical diagnoses.
Since it is already known that specific risk
factors and genes are implicated in some patients who develop AD and
other susceptibility genes are likely to be discovered, it may be too
optimistic to suppose that nutritional approaches will necessarily have
a huge impact on preventing AD or slowing cognitive decline.
Nevertheless, even modest effects could have large public health
implications. The degree to which treatment interventions directed
toward maintaining optimal nutrition and preventing excess weight loss
could slow the disease course requires more rigorous study.
Source:
http://www.archneurol.com.
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