1993 Volume 30 Issue 7 Pages 602-609
The authors investigated causes for weight loss in inpatients with senile dementia, who could take diets. The 81 patients (80±8.3 years of mean age±S.D., 22 males and 59 females) included 48 cases of senile dementia of Alzheimer type (SDAT) and 25 cases of multi-infarct dementia (MID). Controls consisted of 77 non-demented patients (82±9.1 years, 29 males and 48 females) who were admitted because of cerebrovascular or cardiopulmonary diseases. Demented patients showed an average of -1.8±8.5% weight change per year, while that of non-demented patients was +4.4±6.3%, resulting in a significant difference between them (p<0.0001). Between demented males and females, there was no significant difference. In male, SDAT cases showed more weight loss than MID cases (-5.0±5.1% vs +3.3±4.2%, P=0.003), although in females there was no significant difference between SDAT and MID. Even when patients with a wandering tendency or complications were excluded, results essentially did not change. In demented patients, weight change did not correlated with age, amount of dietary intake, length of hospital stay or serum albumin level. However, it correlated with body weight (r=0.26, P=0.014), ADL index (GBS-A) (r=0.22, P=0.04), and with Mini-Mental State Examination score (r=0.23, P=0.048). In multiple regression analysis, the most powerful explanatory variable in demented males was the index for cerebral atrophy. These results confirmed previous studies reporting that reduced dietary intake, complications or hyperactivity do not fully explain weight loss in demented patients. Furthermore, we demonstrated that weight loss was marked in SDAT males and it correlated with severity of dementia and cerebral atrophy, suggesting that some intrinsic factor(s) for weight loss should be considered.
