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The relationship of weight change trajectory with medial temporal lobe atrophy in patients with mild Alzheimer's disease: results from a cohort study.

Droogsma E, van Asselt D, Bieze H, Veeger N, De Deyn PP - Alzheimers Res Ther (2015)

Bottom Line: We hypothesized that patients with more severe MTA at baseline would have a lower body weight at baseline and a faster decrease in body weight during the course of the disease.We found no evidence that MTA is associated with weight loss in AD patients.Moreover, contrary to what was expected, AD patients did not lose but gained weight during follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Geriatric Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, the Netherlands.

ABSTRACT

Introduction: Weight loss has been described in 20% to 45% of patients with Alzheimer's disease (AD) and has been associated with adverse outcomes. Various mechanisms for weight loss in AD patients have been proposed, though none has been proven. This study aimed to elucidate a mechanism of weight loss in AD patients by examining the hypothesis that weight loss is associated with medial temporal lobe atrophy (MTA).

Methods: Patients from the Frisian Alzheimer's disease cohort study (a retrospective, longitudinal study of 576 community-dwelling AD patients) were included when a brain MRI was performed on which MTA could be assessed. To investigate the hypothesis that weight loss is associated with MTA, we investigated whether the trajectory of body weight change depends on the severity of MTA at the time of diagnosis (that is baseline). We hypothesized that patients with more severe MTA at baseline would have a lower body weight at baseline and a faster decrease in body weight during the course of the disease. The generalized linear mixed model (GLMM) was used to determine the relationship of weight change trajectory with MTA severity.

Results: In total, 214 patients (median age 79 years, median MMSE 23, mean weight 73.9 kg) were included. Patients with moderate, severe or very severe MTA at baseline weighed 3.2 to 6.8 kg more than patients with no or mild MTA. During the 3.5 years, patients gained on average 1.7 kg in body weight, irrespective of the severity of their MTA at baseline.

Conclusions: We found no evidence that MTA is associated with weight loss in AD patients. Moreover, contrary to what was expected, AD patients did not lose but gained weight during follow-up.

No MeSH data available.


Related in: MedlinePlus

Trajectory of weight; right MTA score 0 or 1 versus 2, 3 or 4 (results from the univariate GLMM analyses). GLMM, generalized linear mixed model; MTA, medial temporal lobe atrophy.
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Fig4: Trajectory of weight; right MTA score 0 or 1 versus 2, 3 or 4 (results from the univariate GLMM analyses). GLMM, generalized linear mixed model; MTA, medial temporal lobe atrophy.

Mentions: The trajectory of weight per right MTA score is presented in Table 6 and Figure 3. As for the left MTA, we compared the trajectory of weight between patients with a MTA score of 0 or 1, versus patients with a MTA score of 2, 3 or 4 (Table 7, Figure 4). Patients with MTA 0 or 1 weighed less than patients with MTA 2, 3, 4 at any moment during follow-up. In this, an interaction with time (P = 0.001) was observed, depending on the moment during follow-up, patients with MTA 0 or 1 weighed between 3.2 kg (at 6 months) and 6.4 kg (at 18 months) less than patients with MTA 2, 3, 4 (Table 7, Figure 4). Overall, all patients gained on average 0.7 kg in body weight after 2.5 years (Table 7). As for the left MTA, we compared the baseline characteristics between patients with MTA 0 or 1, versus patients with a MTA score of 2, 3 or 4 (Table 8). Patients with MTA 0 or 1 were younger, had a higher MMSE score and used informal care less often at baseline compared to patients with a MTA score of 2, 3 or 4 (Table 8).Table 6


The relationship of weight change trajectory with medial temporal lobe atrophy in patients with mild Alzheimer's disease: results from a cohort study.

Droogsma E, van Asselt D, Bieze H, Veeger N, De Deyn PP - Alzheimers Res Ther (2015)

Trajectory of weight; right MTA score 0 or 1 versus 2, 3 or 4 (results from the univariate GLMM analyses). GLMM, generalized linear mixed model; MTA, medial temporal lobe atrophy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4386098&req=5

Fig4: Trajectory of weight; right MTA score 0 or 1 versus 2, 3 or 4 (results from the univariate GLMM analyses). GLMM, generalized linear mixed model; MTA, medial temporal lobe atrophy.
Mentions: The trajectory of weight per right MTA score is presented in Table 6 and Figure 3. As for the left MTA, we compared the trajectory of weight between patients with a MTA score of 0 or 1, versus patients with a MTA score of 2, 3 or 4 (Table 7, Figure 4). Patients with MTA 0 or 1 weighed less than patients with MTA 2, 3, 4 at any moment during follow-up. In this, an interaction with time (P = 0.001) was observed, depending on the moment during follow-up, patients with MTA 0 or 1 weighed between 3.2 kg (at 6 months) and 6.4 kg (at 18 months) less than patients with MTA 2, 3, 4 (Table 7, Figure 4). Overall, all patients gained on average 0.7 kg in body weight after 2.5 years (Table 7). As for the left MTA, we compared the baseline characteristics between patients with MTA 0 or 1, versus patients with a MTA score of 2, 3 or 4 (Table 8). Patients with MTA 0 or 1 were younger, had a higher MMSE score and used informal care less often at baseline compared to patients with a MTA score of 2, 3 or 4 (Table 8).Table 6

Bottom Line: We hypothesized that patients with more severe MTA at baseline would have a lower body weight at baseline and a faster decrease in body weight during the course of the disease.We found no evidence that MTA is associated with weight loss in AD patients.Moreover, contrary to what was expected, AD patients did not lose but gained weight during follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Geriatric Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, the Netherlands.

ABSTRACT

Introduction: Weight loss has been described in 20% to 45% of patients with Alzheimer's disease (AD) and has been associated with adverse outcomes. Various mechanisms for weight loss in AD patients have been proposed, though none has been proven. This study aimed to elucidate a mechanism of weight loss in AD patients by examining the hypothesis that weight loss is associated with medial temporal lobe atrophy (MTA).

Methods: Patients from the Frisian Alzheimer's disease cohort study (a retrospective, longitudinal study of 576 community-dwelling AD patients) were included when a brain MRI was performed on which MTA could be assessed. To investigate the hypothesis that weight loss is associated with MTA, we investigated whether the trajectory of body weight change depends on the severity of MTA at the time of diagnosis (that is baseline). We hypothesized that patients with more severe MTA at baseline would have a lower body weight at baseline and a faster decrease in body weight during the course of the disease. The generalized linear mixed model (GLMM) was used to determine the relationship of weight change trajectory with MTA severity.

Results: In total, 214 patients (median age 79 years, median MMSE 23, mean weight 73.9 kg) were included. Patients with moderate, severe or very severe MTA at baseline weighed 3.2 to 6.8 kg more than patients with no or mild MTA. During the 3.5 years, patients gained on average 1.7 kg in body weight, irrespective of the severity of their MTA at baseline.

Conclusions: We found no evidence that MTA is associated with weight loss in AD patients. Moreover, contrary to what was expected, AD patients did not lose but gained weight during follow-up.

No MeSH data available.


Related in: MedlinePlus