Alzheimer hastalığında demans düzeyinin vücut kompozisyonuna ve bazal metabolizma hızına etkisi

Öz

Amaç: Alzheimer hastalığı (AH), bilişsel fonksiyonların geri dönüşümsüz kaybı ile karakterize ilerleyici nörodejeneratif ve multifaktoriyel etyolojiye sahip bir hastalıktır. Bu hastalarda gelişen beslenme bozuklukları kognitif yıkımın artmasına, dolayısıyla demansın ilerlemesine neden olabilmektedir. Biz bu çalışmada, AH hastalarında hastalığın evrelerine göre kilo, vücut kütle indeksi (VKİ), yağsız vücut kütlesi ile bazal metabolizma hızı (BMH) arasındaki ilişkiyi araştırmak ve BMH üzerine etkili olabilecek klinik ve laboratuvar bulgularını incelemeyi amaçladık. Gereç ve Yöntem: 108 (44 erkek, 64 kadın) AH hastasının klinik ve demografik özellikleri kayıt edildi. Hastalar Klinik Demans Evrelendirme Ölçeğine göre hafif ve hafif-orta evre AH (Grup 1, n=84) ile orta ve ağır evre AH (Grup 2, n=24) olmak üzere iki gruba ayrıldı. Hastaların kilo, boy, bel çevresi ölçümleri ve laboratuvar tetkikleri kayıt edildi. Hastaların VKİ Quetelet indeksine, yağsız vücut kütlesi Hume denklemi ve BMH düzeyleri de Harris-Benedict denklemine göre hesaplandı. Bulgular: Hastaların ortalama yaşı 71.6±8.2 yıl, ortalama VKİ 30,6±39,8 kg/m2 ve ortalama demans süresi 33,8±29,4 ay olarak saptandı. Grup 1 ve Grup 2 arasında cinsiyet, yaş, VKİ, bel çevresi, demans süreleri açısından fark tespit edilmedi, buna karşın orta ve ağır evre AH hastalarında, hafif evre grubuna göre yağsız vücut kütlesi ve BMH düzeylerinin daha düşük olduğu saptandı (p<0.05). AH hastalarında VKİ düzeyinin, bel çevresinin ve yağsız vücut kütlesinin BMH ile pozitif ilişkili olduğunu saptadık. Yağsız vücut kütlesinin BMH’nı etkileyen bağımsız faktör olduğu tespit edildi (β=0,732, p<0,001, OR=11,06, CI %95 11,07-15,9). Sonuç: İleri evre AH hastalarında kilo kaybının özellikle yağsız vücut kütlesindeki azalmanın hastaların yaşam kalitesini olumsuz etkileyebileceğini, hastalığın başlangıç döneminden itibaren doğru beslenme ve egzersiz programlarının uygulanmasının önemli olduğunu düşünmekteyiz.

Anahtar Kelimeler

• Alzheimer hastalığı
• demans
• bazal metabolizma hızı

The effect of dementia level on body composition and basal metabolic rate in Alzheimer’s disease

Öz

Purpose: Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by irreversible loss of cognitive functions and has multifactorial etiology. Nutritional disorders in Alzheimer's disease (AD) patients may lead to an increase in cognitive impairment and subsequent progression of dementia. In this study, we aimed to investigate the relationship of basal metabolic rate (BMR) with weight, body mass index (BMI), lean body mass in AD patients and to clarify the clinical and laboratory findings that may affect BMR.

Materials and Methods: The clinical and demographic characteristics of 108 patients (44 male, 64 women) were recorded. Patients were divided into two groups according to Clinical Dementia Rating Scale as mild and mild-moderate AD (Group 1, n=84) and moderate and severe AD (Group 2, n=24). Weight, height, waist circumference measurements and laboratory tests were recorded.

Results: The mean age of the patients was 71.6±8.2 years, the mean BMI was 30.6±39.8 kg/m2 and the mean dementia was 33.8±29.4 months. No difference was found between Group 1 and Group 2 in terms of gender, age, BMI, waist circumference, dementia duration, whereas lean body mass and BMR levels were found to be lower in moderate and severe AD patients compared to mild stage group (p<0.05).  BMI, waist circumference and lean body mass were positively correlated with BMR in AD patients. Lean body mass was found to be an independent factor affecting BMR (β=0.732, p<0.001, OR=11.06, CI 95%11.07-15.9).

Conclusion: We found a significant weight loss, especially in lean body mass, that may adversely affect the quality of life in advanced AD patients. It is important to implement proper nutrition and exercise programs from the onset of the disease.

Anahtar Kelimeler

• Alzheimer’s disease
• dementia
• basal metabolic rate

Kaynakça

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