J Clin Neurol.  2019 Jul;15(3):292-300. 10.3988/jcn.2019.15.3.292.

Association of Nutritional Status with Cognitive Stage in the Elderly Korean Population: The Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease

• Jang JW
• Kim Y
• Choi YH
• Lee JM
• Yoon B
• Park KW
• Kim SE
• Kim HJ
• Yoon SJ
• Jeong JH
• Kim EJ
• Jung NY
• Hwang J
• Kang JH
• Hong JY
• Choi SH

• KMID: 2451111
• DOI: http://doi.org/10.3988/jcn.2019.15.3.292

Abstract

BACKGROUND AND PURPOSE
Epidemiological studies have suggested the presence of strong correlations among diet, lifestyle, and dementia onset. However, these studies have unfortunately had major limitations due to their inability to fully control the various potential confounders affecting the nutritional status. The purpose of the current study was to determine the nutritional status of participants in the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease (KBASE) and to identify clinical risk factors for being at risk of malnutrition or being malnourished.
METHODS
Baseline data from 212 participants [119 cognitively unimpaired (CU), 56 with mild cognitive impairment (MCI), and 37 with dementia] included in the KBASE database were analyzed. All participants underwent a comprehensive cognitive test and MRI at baseline. The presence of malnutrition at baseline was measured by the Mini Nutritional Assessment score. We examined the cross-sectional relationships of clinical findings with nutritional status using multiple logistic regression applied to variables for which p<0.2 in the univariate analysis. Differences in cortical thickness according to the nutritional status were also investigated.
RESULTS
After adjustment for demographic, nutritional, and neuropsychological factors, participants with dementia had a significantly higher odds ratio (OR) for being at risk of malnutrition or being malnourished than CU participants [OR=5.98, 95% CI=1.20-32.97] whereas participants with MCI did not (OR=0.62, 95% CI=0.20-1.83). Cortical thinning in the at-risk/malnutrition group was observed in the left temporal area.
CONCLUSIONS
Dementia was found to be an independent predictor for the risk of malnutrition compared with CU participants. Our findings further suggest that cortical thinning in left temporal regions is related to the nutritional status.

Keyword

nutritional status; dementia; cerebral cortex

MeSH Terms

Aged*
Aging*
Alzheimer Disease*
Brain*
Cerebral Cortex
Dementia
Diet
Early Diagnosis*
Epidemiologic Studies
Humans
Life Style
Logistic Models
Magnetic Resonance Imaging
Malnutrition
Mild Cognitive Impairment
Nutrition Assessment
Nutritional Status*
Odds Ratio
Risk Factors
Temporal Lobe

Figure

• 

  Fig. 1 Cortical thinning was associated with the risk of malnutrition in the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease cohort. Regions with significant between-group differences in cortical thickness appeared in the left temporal area after adjustment for covariates. Clusters where the thickness was less in the at-risk/malnutrition group than in the well-nourished group are indicated in red.

• 

  Fig. 2 Regions showing significant partial correlations between Mini Nutritional Assessment score and regional cortical thickness in the left temporal pole after adjustment for covariates. Clusters where the negative correlation was significantly stronger in all of the participants are indicated in blue.

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