Alzheimer hastalarında erken evrede beslenme ve kas gücünde bozulma var mı?

Öz

Amaç: Çalışmamızın amacı, erken ve orta evre Alzheimer hastaları ile Alzheimer hastalığı olmayan hastaları beslenme, kas gücü ve kırılganlık açısından karşılaştırmaktır. Gereç ve Yöntemler: Çalışmamız, 1 Nisan - 1 Aralık 2024 tarihleri arasında üçüncü basamak bir sağlık merkezinin polikliniğinde yürütülen kesitsel bir çalışmadır. Alzheimer hastalığı, Ulusal Yaşlanma Enstitüsü-Alzheimer Derneği Çalışma Grupları kriterlerine göre teşhis edilmiştir. Mini mental durum muayenesine göre 20-24 puan hafif, 10-19 puan orta dereceli demans hastası olarak kabul edilmiştir. Yetersiz beslenme için MNA-SF (Mini Beslenme Değerlendirmesi-Kısa Form) testi, kas gücü için El Kavrama Gücü, kırılganlık için FRAIL anketi uygulanmıştır. Bulgular: Alzheimer hastalığı olan hastalar (n=32; 20 erken evre - 12 orta evre) ile Alzheimer hastalığı olmayan kontrol hastaları (n=32) arasında yaş ve cinsiyet açısından anlamlı bir fark bulunmadı (p=0,279; p=0,768). MNA-SF ve kas kuvveti Alzheimer grubunda kontrol grubuna göre anlamlı olarak düşüktü (p=0,009; p<0,001). FRAIL skoru Alzheimer grubunda kontrol grubuna göre anlamlı olarak yüksekti (p=0,010). MNA-SF ve kas kuvveti erken evre Alzheimer grubunda (n=20) kontrol grubuna (n=32) göre istatistiksel olarak anlamlı şekilde düşüktü (p=0,025, p=0,006). FRAIL skoru erken evre Alzheimer grubunda (n=20) kontrol grubuna (n=32) göre istatistiksel olarak anlamlı şekilde yüksekti (p=0,011). Sonuçlar: Çalışmamız, Alzheimer hastalığının erken evrede bile bireylerin beslenme durumunu ve kas gücünü olumsuz etkilediğini göstermektedir. Bu nedenle, Alzheimer hastalarının yetersiz beslenme riski ve kas gücü açısından düzenli olarak taranması önemlidir.

Anahtar Kelimeler

• beslenme
• kas gücü
• kırılganlık
• Alzheimer hastalığı

Are nutrition and muscle strength impaired in Alzheimer's patients at an early stage?

Öz

Aim: The aim of our study is to compare early and mid-stage Alzheimer's disease patients and patients without Alzheimer's disease in terms of nutrition, muscle strength and frailty. Materials and Methods: Our study is a cross-sectional study conducted in the outpatient clinic of a tertiary health centre between 1 April and 1 December 2024. Alzheimer's disease was diagnosed according to the National Institute on Aging-Alzheimer's Association Working Groups criteria. According to the minimal status examination, 20-24 were considered mild and 10-19 were considered moderate dementia patients. MNA-SF (Mini Nutritional Assessment-Short Form) test for malnutrition, Handgrip strength (HGS) for muscle strength, FRAIL questionnaire for frailty were applied. Results: There was no significant difference between Alzheimer's disease patients (n=32; 20 early stage- 12 middle stage) and control patients without Alzheimer's disease (n=32) in terms of age and gender (p=0.279, p=0.768). MNA-SF and muscle strength were significantly lower in the Alzheimer's group compared to the control group (p=0.009, p<0.001). FRAIL score was significantly higher in the Alzheimer's group compared to the control group (p=0.010). MNA-SF, muscle strength were statistically significantly lower in the early stage Alzheimer's group (n=20) compared to the control group (n=32) (p=0.025, p=0.006). FRAIL score was statistically significantly higher in the early stage Alzheimer's group (n=20) compared to the control group (n=32) (p=0.011). Conclusion: Our study shows that Alzheimer's disease negatively affects the nutritional status and muscle strength of individuals even in the early stage. Therefore, it is important to regularly screen Alzheimer's patients for malnutrition risk and muscle strength.

Anahtar Kelimeler

• nutrition
• muscle strength
• fraility
• Alzheimer’s disease

Kaynakça

1. Bitsch M, Foss NB, Kristensen BB, Kehlet H. Acute cognitive dysfunction after hip fracture: frequency and risk factors in an optimized, multimodal, rehabilitation program. Acta Anaesthesiol Scand 2006; 50: 428-36.
2. Akkan Suzan A. A bibliometric and altmetric analysis of Alzheimer’s disease: Top 100 articles. Turk J Geriatr 2022; 25: 3.
3. Grossberg GT. The ABC of Alzheimer's disease: behavioral symptoms and their treatment. Int Psychogeriatr 2002; 14: 27-49.
4. Turkish Statistical Institute (TurkStat). Results of Address Based Population Registration System, 2025. Available from: https://veriportali.tuik.gov.tr [Accessed 9 February 2026].
5. Turkish Statistical Institute (TurkStat). Statistics on Elderly, 2023. Available from: https://data.tuik.gov.tr [Accessed 13 March 2025].
6. Aisen PS, Schneider LS, Sano M, Diaz-Arrastia R, van Dyck CH, Weiner MF et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial. JAMA 2008; 300: 1774-83.
7. Loef M, Schrauzer GN, Walach H. Selenium and Alzheimer's Disease: A Systematic Review. J Alzheimers Dis 2011; 26: 81-104.
8. Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet 2019; 393: 2636-46.

9. Bauer JM, Sieber CC. Sarcopenia and frailty: a clinician’s controversial point of view. Exp Gerontol 2008; 43: 674-8.
10. McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups. Alzheimers Dement 2011; 7: 263-9.
11. Perneczky R, Wagenpfeil S, Komossa K, Grimmer T, Diehl J, Kurz A. Mapping scores onto stages: mini-mental state examination and clinical dementia rating. Am J Geriatr Psychiatry 2006; 14: 139-44.
12. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-98.
13. Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T et al. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 2009; 13: 782-8.
14. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48: 601.
15. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging 2012; 16: 601-8.
16. Shatenstein B, Kergoat M, Reid I, Chicoine ME. Dietary intervention in older adults with early-stage Alzheimer dementia: early lessons learned. J Nutr Health Aging 2008; 12: 461-9.
17. Kul B, Tulek Z. Optimal Care in the Management of Eating Difficulties in Patients with Dementia. J Geriatr Sci 2024; 7: 156-66.
18. Buchman AS, Wilson RS, Boyle PA, Bienias JL, Bennett DA. Grip strength and the risk of incident Alzheimer's disease. Neuroepidemiology 2007; 29: 66-73.
19. Gómez-Gómez ME, Zapico SC. Frailty, Cognitive Decline, Neurodegenerative Diseases and Nutrition Interventions. Int J Mol Sci 2019; 20: 2842.
20. Chi HC, Ma LZ, Wang ZB, Sheng ZH, Liu JY, Mi YC et al. Associations of Frailty with Neuropsychiatric Symptoms of Alzheimer's Disease: A Longitudinal Study. J Alzheimers Dis 2024; 98: 629-42.