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Previous issue date: 2012-02-24 / Malnutrition is one of the most important and common condition among the elderly that negatively affects health and quality of life. With ageing, the loss of weight is an expected physiological process. However, in the presence of dementia, the weight loss is involuntary and the risk of malnutrition becomes imminent. The risk of malnutrition may be present even before clinical diagnosis of mental illness. Some studies suggest that an alteration in the nutritional status might appear as a predictor of severity and progression of cognitive decline. The present study aimed to investigate the independent association of malnutrition risk with depressive symptoms, memory deficit or dementia in older adults. This is a cross-sectional population-based study that 176 participants aged 60 years and older were evaluated for nutritional risk, depressive symptoms, cognitive function. Data was collected from structured interviews and assessments in the participants homes and in the hospital for trained staff. The Mini Nutritional Assessment (MNA?) was used to assess the risk of malnutrition. Depressive symptoms were screened using the short version of Geriatric Depression Scale (GDS-15). For the cognitive assessment a board of certified neurologists, psychiatrists and neuropsychologists used validated tests combined with golden standard clinical criteria. Cognitive assessment was taken using the Mini-Mental State Examination (MMSE), word list memory and constructional praxis from the standard neuropsychological battery of Consortium to Establish a Registry for Alzheimer s Disease (CERAD), and Wechsler verbal and logical memory test. The functional status was evaluated using the Katz Index and Pfeffer Scale. The clinical diagnosis of dementia was based on the recommendations from the National Institute on Aging-Alzheimer s Association workgroups on diagnostic guidelines for Alzheimer s disease. The results showed that means variations of malnutrition risk were significantly different (P<.001) comparing elderly considered normal (26.9?2.8) with those with depressive symptoms (25.0?3.5), memory deficit (25.5?3.8), memory deficit plus depressive symptoms (24.0?3.3) and dementia (21.9?5.9). A multivariate analysis model with a robust estimation of Prevalence Ratios (PR) using the Poisson regression demonstrated that dementia (PR:14.006, P<.001), memory deficit plus depressive symptoms (PR:5.759, P=.003), depressive symptoms (PR:5.350, P=.014); memory deficit (PR:3.338, P=.046), and 70-79 years age group (PR:0.457, P=.031) were independent factors associated with malnutrition risk. These results were controlled for gender, marital status, educational level and income. In conclusion, the most important finding was the independent relationship with memory deficit and malnutrition risk. These results suggest that nutritional disturbances may start earlier than previously expected by others studies. None study detected malnutrition risk combining objective measurements of precocious memory impairment with careful observance of depressive symptoms in a robust controlled analysis. / A desnutri??o ? uma das condi??es mais importantes e frequentes entre os idosos, afetando, negativamente, a sa?de e a qualidade de vida. Com o envelhecimento, a perda de peso faz parte de um processo fisiol?gico normal. Entretanto, na presen?a de quadro demencial, a perda ponderal ? involunt?ria e o risco de desnutri??o tornase iminente. O risco de desnutri??o pode estar presente mesmo antes do diagn?stico cl?nico de doen?a mental. Alguns estudos sugerem que a altera??o do estado nutricional pode aparecer como preditor de severidade e progress?o de decl?nio cognitivo. O presente estudo objetivou investigar a associa??o independente do risco de desnutri??o com sintomas depressivos, d?ficit de mem?ria e dem?ncia em idosos. Este ? um estudo populacional transversal em que 176 participantes com idade igual ou superior a 60 anos foram avaliados em rela??o ao risco nutricional, sintomas depressivos e fun??o cognitiva. Os dados foram coletados a partir de entrevista estruturada no domic?lio dos participantes e avalia??es realizadas no hospital por equipe treinada. A Mini Avalia??o Nutricional (MAN?) foi utilizada para avaliar o risco de desnutri??o. Sintomas depressivos foram rastreados atrav?s da vers?o reduzida da Escala de Depress?o Geri?trica (EDG-15). Para a avalia??o cognitiva, uma equipe de neurologistas, psiquiatras e neuropsic?logos utilizaram a combina??o de testes validados. A avalia??o cognitiva foi verificada atrav?s do Mini- Exame do Estado Mental (MEEM), lista de palavras e praxia construtiva do Consortium to Establish a Registry for Alzheimer s Disease (CERAD) e o teste de mem?ria verbal e l?gica de Wechesler. O estado funcional foi avaliado atrav?s do ?ndice de Katz e Escala de Pfeffer. O diagn?stico cl?nico de dem?ncia foi baseado nas recomenda??es do National Institute on Aging-Alzheimer s Association workgroups on diagnostic guidelines for Alzheimer s disease. Os resultados demonstraram que as varia??es entre as m?dias de risco de desnutri??o foram significativamente diferentes (P<.001), comparando idosos considerados normais (26,9?2,8) com os que apresentavam sintomas depressivos (25,0?3,5), d?ficit de mem?ria (25,5?3,8), d?ficit de mem?ria somado a sintomas depressivos (24,0?3,3) e dem?ncia (21,9?5,9). A partir de uma estimativa robusta da Raz?o de Preval?ncia (RP) usando a regress?o de Poisson, o modelo de an?lise multivariada demonstrou que dem?ncia (PR: 14,006; P<.001), d?ficit de mem?ria mais sintomas depressivos (PR: 5,759; P=.003), sintomas depressivos (PR: 5,350; P=.014); d?ficit de mem?ria (PR: 3,338; P=.046), e grupo et?rio entre 70-79 anos (PR: 0,457; P=.031) foram fatores independentes associados com risco de desnutri??o. Estes resultados foram controlados para sexo, estado civil, escolaridade e renda. Em conclus?o, o achado mais importante foi a rela??o independente com d?ficit de mem?ria e risco de desnutri??o. Estes resultados sugerem que os dist?rbios nutricionais podem come?ar mais precocemente do que anteriormente previsto por outros estudos. Nenhum estudo detectou risco de desnutri??o combinando medidas objetivas de perda de mem?ria precoce com cuidadosa observ?ncia de sintomas depressivos em uma an?lise robusta controlada.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2664 |
| Date | 24 February 2012 |
| Creators | Galdino, Tatiana Pizzato |
| Contributors | Silva Filho, Irenio Gomes da |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 600, 2296420844541114010 |
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