Search

Introduction.- In former research we showed that 19% of home living geriatric patients suffered from malnutrition. Fifty-one percent were at risk for malnutrition. Aim of this study is to define determinants related to malnutrition. Methods.- Cross-sectional data from 173 patients was obtained at first hospital visit. Nutritional status was assessed by means of the Mini Nutritional Assessment (MNA 23.5 indicative of satisfactory nutritional status). Possible determinants of malnutrition were categorized into somatic factors (medication use, co morbidity), social factors (children, marital status), psychological factors (Mini Mental State Examination [MMSE] and Geriatric Depression Scale [GDS]) and functional status (Activities of Daily Life (ADL) and Instrumental Activities of Daily Life [IADL]). Both linear regression (with MNA as a dependent parameter) and logistic regression (MNA

Background: In cardiovascular (CV) epidemiology, interest increases in studying etiologic and prognostic implications of early structural or functional changes of the large arteries. Examples of such measurements are pulse wave velocity (PWV), carotid intima-media thickness (CIMT) and augmentation index (AIx). PWV and CIMT are established markers of CV risk whereas the role of AIx as indicator of risk has not fully been established. Therefore, our aim was to relate AIx to CV risk and to compare the magnitude of relations of PWV, CIMT and AIx to CV risk. Methods: Two hundred and ninty-nine men free from cardiovascular disease (mean age 59.2 years), participated in this cross-sectional study. Cardiovascular risk profile was determined and 10-year coronary heart disease risk was estimated using the Framingham risk score (FRS). PWV, CIMT and AIx were measured and data were analyzed using linear regression models. Results: PWV and CIMT were strongest related to FRS whereas AIx showed the weakest relation. Ten-year coronary heart disease risk increased 6.24%, 95% confidence interval (CI) [5.11;7.37] per standard deviation (S.D.) increase in PWV, 6.39% [5.24;7.54] per S.D. increase in CIMT and 2.50% [1.19;3.80] per S.D. increase in AIx. Conclusion: In middle aged and elderly men AIx is related to CV risk. However, compared with AIx, PWV and CIMT seem better markers of cardiovascular risk.

Rationale: Little information exists on the relation between malnutrition and brain atrophy and cerebrovascular lesions. Methods: In 359 geriatric outpatients nutritional status was assessed by MNA and by vitamin B1, B6, B12, and folic acid levels. White Matter Hyperintensities (WMHs), Global Cortical brain Atrophy (GCA) or Medial Temporal lobe Atrophy (MTA) on MRI were quantified using visual rating scales. Cognitive functioning was assessed by neuropsycological examination (n = 192) or by MMSE. Logistic regression analyses were performed to associate MNA categories and micronutrients (per SD decrease or absolute deficiency) with severe WHMs, GCA and MTA. All analyses were adjusted for age, sex, education, comorbidities, alcohol use and smoking and MNA scores were additionally adjusted for vitamin B levels. Analyses were repeated after stratification for cognitive status (healthy n = 94, unhealthy n = 265). Results: Mean age was 80 (SD 7) years, 13% were malnourished, and 55% were at risk of malnutrition. Vitamin deficiencies were observed in 5% (B1), 1.7% (B6), 8.1% (B12), and 1.9% (folic acid). Malnutrition and risk of malnutrition were associated with an increased risk of having severe WHMs, ORs (95% CI) 2.15 (1.10-4.22) and 2.98 (1.25-7.09). Results held after additional adjustment for B-vitamin status. Stratification for cognitive status showed similar results in cognitively (un)healthy patients. Lower vit B1 and vit B12 levels were associated with increased risk of WMHs [OR per SD decrease vit B1 1.49 (1.08-2.08), OR for absolute vit B12 deficiency 2.55 (1.04-6.26)]. Conclusion: Malnutrition and vit B1 and B12 deficiencies were associated with increased risk of WMHs, independent of each other and of cognitive status. Underlying mechanisms need to be further clarified and it also needs to be studied whether these findings are modifiable by nutritional interventions.

Background/Aims: The metabolic syndrome (MeSy) may be related to Alzheimer’s disease (AD). Our aims were to investigate the association of the MeSy with incident dementia in a multi

The apolipoprotein E (APOE) gene may act differently in young and old persons, known as antagonistic pleiotropy. We therefore examined the prospective associations between the APOE ε4 allele and cognitive functioning, and the modifying effect of age, in 375 nondemented adults (mean age 57 ± 10 years; follow-up period 3.8 ± 0.2 years) with available data on APOE genotype and cognitive functioning, within the SMART-MR (Second Manifestations of ARTerial disease-Magnetic Resonance) cohort study. Neuropsychological tests assessing memory performance and executive functioning were performed at baseline and follow-up, and composite z-scores were calculated. Age significantly modified the association of APOE ε4 with change in memory performance (p interaction = 0.02). In persons ≤ 57 years (median split), an APOE ε4 allele was associated with an increase in immediate recall (B = 0.42; 95% confidence interval [CI], 0.17 to 0.66) and delayed recall (B = 0.37; 95% CI, 0.09 to 0.64), while in persons > 57 years, an APOE ε4 allele was associated with decline in immediate recall (B = −0.25; 95% CI, −0.52 to 0.01). Our findings suggest that the APOE ε4 allele has a differential effect on change in verbal memory performance depending on age, consistent with the hypothesis of antagonistic pleiotropy.