阿尔茨海默病病人吞咽功能、营养状态与认知功能的相关性研究

doi:10.3969/j.issn.1003-9198.2024.06.009

摘要/Abstract

摘要： 目的探讨AD病人吞咽功能、营养状况与认知功能的关系。方法选择2019年10月至2021年11月在南京医科大学第一附属医院(江苏省人民医院)老年神经科住院的60~79岁的AD病人56例为AD组,另选取同期性别、年龄相匹配的体检病人60例作为对照组。收集2组TC、TG、HDL-C、LDL-C、FPG、UA、白蛋白及Hb等实验室检查指标,并完成微型营养评定简表(MNA-SF)及洼田饮水试验的评估,比较2组间的差异。分别通过吞咽障碍程度分级量表及MMSE评估AD病人吞咽功能障碍分级及认知功能,探讨AD病人认知功能、吞咽功能及营养状态之间的关系。结果 AD组Hb、白蛋白水平以及MNA-SF评分均显著低于对照组(P＜0.05);AD组营养状况随着吞咽障碍程度分级的增加而下降(P＜0.05);Spearman相关性分析表明,AD病人的MNA-SF评分与MMSE评分呈正相关(r=0.554,P＜0.05)。结论 AD病人的吞咽功能及营养状况明显下降,并且随着吞咽功能下降,营养不良逐渐加重,同时AD病人认知功能与营养状况存在显著相关性。在临床工作中应加强对AD病人吞咽功能的筛查,增强营养支持,积极改善AD病人的认知功能和生活状况。

关键词: 阿尔茨海默病, 吞咽功能障碍, 认知功能, 营养不良

Abstract: Objective To investigate the relationship between swallowing function,nutritional status and cognitive function in the elderly patients with Alzheimer’s disease (AD). Methods A total of 56 elderly patients with AD hospitalized in Department of Geriatrics of the First Affiliated Hospital of Nanjing Medical University (AD group) and 60 normal elderly matched for gender, age from October 2019 to November 2021 (control group) were enrolled in this study. The data of the laboratory indexes including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), uric acid (UA), albumin and hemoglobin (Hb) were collected and compared between the two groups. Two groups underwent the assessment of short-form micronutrient assessment (MNA-SF), Water Swallowing Test, Swallowing Disorder Scale and The Mini-Mental State Examination (MMSE) scale. The relationship of cognitive function with swallowing function and nutritional status in the elderly AD patients was explored. Results The levels of Hb, albumin and the MNA-SF score in AD group were significantly lower than those in control group (P<0.05). The nutritional status of AD patients decreased with the increase of the degree of swallowing disorder (P<0.05). Spearman correlation analysis showed that there was a positive correlation between MMSE score and MNA-SF score (r=0.554, P<0.05). Conclusions The swallowing function and nutritional status of the elderly AD patients are significantly decreased, and there is a positive correlation between the nutritional status and the cognitive function in the elderly AD patients. In clinical work, we should strengthen the screening of the swallowing function, enhance the nutritional support, and actively improve the cognitive function and living conditions of the elderly AD patients.

Key words: Alzheimer’s disease, dysphagia, cognition impairment, malnutrition

中图分类号:

R749.16

李清扬, 王婵娟, 王峥. 阿尔茨海默病病人吞咽功能、营养状态与认知功能的相关性研究[J]. 实用老年医学, 2024, 38(6): 577-581.

LI Qingyang, WANG Chanjuan, WANG Zheng. Study on the correlation of cognitive function with swallowing function and nutritional status in the elderly patients with Alzheimer’s disease[J]. Practical Geriatrics, 2024, 38(6): 577-581.

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