目的:探讨神经精神症状(NPS)与营养状况的关系,并探索它们在阿尔茨海默病(AD)连续体上的共同调节大脑区域。
方法:纵向,观察性队列研究。
方法:数据来自中国影像学,生物标志物,以及2021年6月1日至2022年12月31日之间的生活方式研究。
方法:总的来说,432名AD连续体患者,包括遗忘型轻度认知障碍和AD痴呆,在基线评估,仅165例患者完成了(10.37±6.08)个月的随访。
方法:使用迷你营养评估(MNA)和神经精神量表(NPI)评估营养状况和NPS,分别。分析了通过饮食营养相关脑区的伪连续动脉自旋标记测量的校正脑血流量(cCBF)。使用广义线性混合模型检查基线时NPS与随后营养状况变化之间的关联以及NPS严重程度变化与营养状况之间的关联。
结果:左壳核cCBF增加与营养不良有关,一般NPS,情感症状,多动症(P<0.05)。一般NPS的存在(β=-1.317,P=0.003),情感症状(β=-1.887,P<0.001),基线时的食欲/进食障碍(β=-1.714,P<0.001)与随访期间MNA评分下降相关。一般NPI得分越高(β=-0.048),情感症状(β=-0.181),和食欲/进食障碍(β=-0.416;所有P<0.001)在校正混杂因素后与较低的MNA评分纵向相关。
结论:我们发现基线NPS是AD连续体营养状况下降的预测因子。情感症状和食欲/进食障碍的严重程度越严重,营养状况越差。此外,壳核的异常灌注可能调节营养不良和NPS之间的关系,这表明了他们潜在的共同神经调控基础。
To investigate the association between neuropsychiatric symptoms (NPS) and nutritional status, and explore their shared regulatory brain regions on the Alzheimer\'s disease (AD) continuum.
A longitudinal, observational cohort
study.
Data were collected from the Chinese Imaging, Biomarkers, and Lifestyle
study between June 1, 2021 and December 31, 2022.
Overall, 432 patients on the AD continuum, including amnestic mild cognitive impairment and AD dementia, were assessed at baseline, and only 165 patients completed the (10.37 ± 6.08) months\' follow-up.
The Mini-Nutritional Assessment (MNA) and Neuropsychiatric Inventory (NPI) were used to evaluate nutritional status and NPS, respectively. The corrected cerebral blood flow (cCBF) measured by pseudo-continuous arterial spin labeling of the dietary nutrition-related brain regions was analyzed. The association between the NPS at baseline and subsequent change in nutritional status and the association between the changes in the severity of NPS and nutritional status were examined using generalized linear mixed models.
Increased cCBF in the left
putamen was associated with malnutrition, general NPS, affective symptoms, and hyperactivity (P < 0.05). The presence of general NPS (β = -1.317, P = 0.003), affective symptoms (β = -1.887, P < 0.001), and appetite/eating disorders (β = -1.714, P < 0.001) at baseline were associated with a decline in the MNA scores during follow-up. The higher scores of general NPI (β = -0.048), affective symptoms (β = -0.181), and appetite/eating disorders (β = -0.416; all P < 0.001) were longitudinally associated with lower MNA scores after adjusting for confounding factors.
We found that baseline NPS were predictors of a decline in nutritional status on the AD continuum. The worse the severity of affective symptoms and appetite/eating disorders, the poorer the nutritional status. Furthermore, abnormal perfusion of the
putamen may regulate the association between malnutrition and NPS, which suggests their potentially common neural regulatory basis.