Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Associations of Cognitive Function and Dietary Factors in Elderly Patients with Alzheimer's Disease

알쯔하이머병 노인들의 인지기능과 관련된 식이 요인

  • Jung, Kyong-Ah (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Lee, Yo-A (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Kim, Seong-Yoon (Department of Psychiatry, Seoul Asan Medical Center) ;
  • Jang, Nam-Soo (Department of Nutritional Science and Food Management, Ewha Womans University)
  • 정경아 (이화여자대학교 생활환경대학 식품영양학과) ;
  • 이요아 (이화여자대학교 생활환경대학 식품영양학과) ;
  • 김성윤 (서울아산병원 정신과) ;
  • 장남수 (이화여자대학교 생활환경대학 식품영양학과)
  • Published : 2008.12.31
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Abstract

The purpose of this study was to investigate nutrients or food factors related to cognitive function of elderly having Alzheimer's disease. In this study 38 subjects who were over 65 years old have participated in dementia clinic at A medical center. After they were diagnosed to Alzheimer's Disease (AD) through blood analysis, neuropsychological test, brain image and interview by medical specialist, we examined for their general information, anthropometry, blood pressure and dietary intakes. Dietary intakes were investigated using the 24-hour recall record. Energy intake was adequate and the energy composition of carbohydrate, protein and fat was 60.8 : 16.2 : 23.0, but dietary intakes of calcium, vitamin A and folate were less than 75% of the recommended intake levels for Koreans. The multiple regression analysis adjusted with age, sex and educational level showed that cognitive function was positively related to intakes of zinc, fishes and shellfishes, beans & nuts, sugars and fats, and negatively related to intakes of plant calcium and eggs. These results indicate that intakes of specific nutrients or food groups are associated with the specific domains of cognitive function in elderly with AD.

본 연구는 2007년 2월부터 5월까지 서울에 위치한 A 대학병원 치매클리닉에 내원한 65세 이상 노인 38명을 대상으로 영양섭취 상태와 인지기능에 관련이 있는 영양소 및 식품의 요인을 알아보고자 실시되었으며 연구결과는 다음과 같다. 알쯔하이머병 노인의 평균연령은 75.8 ${\pm}$ 5.8세로 남녀 성비에서 여자 노인의 비율이 더 높았으며, 체질량지수 과체중과 비만 범위의 분포가 가장 높게 나타났다. 섭취한 총 열량은 1,656.4 ${\pm}$ 528.1 kcal로 2005 국민 건강.영양조사와 비교하여 단백질, 지방, 철분, 칼륨, 비타민 Bl, 비타민 B2, 나이아신, 비타민 C는 더 많이 섭취하였고, 당질, 섬유소, 칼슘, 인, 나트륨, 비타민 A는 더 적게 섭취하는 것으로 나타났다. 식품군별 섭취량에서는 채소류를 309.0 ${\pm}$ 152.4 g로 가장 많이 섭취하였고, 설탕은 7.2 ${\pm}$ 9.3 g로 가장 적게 섭취한 것으로 나타났다. 알쯔하이머병 노인의 인지기능과 관련이 있는 식이요인은 주의집중력에서 식물성 칼슘이 부정적으로 관련이 있는 것으로 나타났고, 언어능력에서는 아연이, 기억력에서는 생선 및 어패류, 두류 및 종실류, 당류군의 섭취가 긍정적인 관련성을 가지는 것으로 나타났다. 간이정신상태검사의 시간지남력에서 계란은 인지기능과 부정적으로 관련성을 가지는 것으로 나타났으며 기억회상에는 지방, 시공간구성력에는 당류의 섭취가 인지기능에 긍정적으로 관련이 있는 요인으로 나타났다. 본 연구의 결과에서 알쯔하이머병 노인들의 인지기능과 식품 및 영양소의 섭취가 관련이 있다는 것을 알 수 있었다. 그러나 대조군이 없는 연구이므로 향후 알쯔하이머병이 없는 노인들을 포함한 비교연구와 시간경과에 따른 식이섭취 양상과 인지기능 상태에 대한 전향적인 연구가 필요할 것으로 사료된다. 더 나아가 알쯔하이머병 노인들에게 나타날 수 있는 식사와 관련한 이상행동을 고려하여 인지기능의 세분화 된 특정 영역과 밀접하게 관련된 식이요인에 대한 심층적인 연구를 통하여 알쯔하이머병 노인들의 식사의 질 향상과 더불어 이상행동의 예후 또한 좋게 하고 삶의 질을 높이는데 기여할 수 있을 것이다.

Keywords

References

  1. Jin BS, Jeon MY. A comparison of depression and anxiety in Alzheimer's disease and vascular disease. J Korea Gerontol Soc 1999; 19(2): 47-57
  2. Korea Institute for Health and Social Affairs, Study on Development of Mapping in Dementia Management; 1997
  3. Korean Dementia Association. Dementia a clinical approach. Seoul, Academia; 2006. p.75-95
  4. Woo JI, Lee JH, Yoo KY, Hong JP, Kim CY, Kim YI, Lee KW. Prevalence of Dementia in the Elderly Residents of a Rural Community in Korea. J Korean Neuropsychiatr Assoc 1997; 36 (1): 92-101
  5. Kim HC. Assessment of Clinical Progression in Alzheimer's Disease with Special Reference to Global Deterioration Scale (GDS) and Functional Assessment Staging (FAST). J Korean Soc Biol Ther Psychiatry 2002; 8(2): 354-366
  6. Barranco-Quintana JL, Allam MF, Del Castillo AS, Navajas RF. Risk factors for Alzheimer's disease. Rev Neurol 2005; 40(10): 613-618
  7. Lindsay J, Laurin D, Verreault R, Hebert R, Helliwell B, Hill GB, McDowell I. Risk factors for Alzheimer's disease: a prospective analysis from the Canadian Study of Health and Aging. Am J Epidemiol 2002; 156(5): 445-453
  8. Lee YS, Kim HK. Nutritional status and cognitive status of the elderly using public health center in Ulsan. Korean J Nutr 2002; 35(10): 1070-1080
  9. Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer's disease. Ann Neurol 2006; 59(6): 912-921 https://doi.org/10.1002/ana.20854
  10. Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Wilson RS, Aggarwal N, Schneider J. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol 2003; 60(7): 940-946 https://doi.org/10.1001/archneur.60.7.940
  11. Kang HK. Effect living condition and aging on food intake and cognitive function in Korea [dissertation]. Seoul: Ewha womans University; 2000
  12. Rahman A, Sawyer Baker P, Allman RM, Zamrini E. Dietary factors and cognitive impairment in community-dwelling elderly. J Nutr Health Aging 2007; 11(1): 49-54
  13. Kim JH, Kang SA, Ahn HS, Jung IK, Lee L. Relationship between cognitive function and dietary patterns in Korean elderly women. Korean J Nutr 1998; 31(9): 1457-1467
  14. Park SO, Han SS, Ko YS, Kim YJ, Lee HS, Kang NE, Lee JH, Kim WK, Kim SH. A study on the relations between dietary intake and cognitive function in the elderly. Korean J Dietary Culture 1992; 7(2): 149-155
  15. Lee J. A study on the nutrient intake of hospital stay demented elderly dementia patients having general Diet [dissertation]. Seoul: Dankook University; 2006
  16. Kang YW, Na DL. Seoul neuropsychological screening battery. Incheon: Human Brain Research & Consulting Co.; 2003
  17. Report on the Asia-pacific perspective: redefining obesity and its treatment, International Obesity Task Force; 2000
  18. The Korean Nutrition Society, Dietary Reference Intakes for Koreans; 2005
  19. Ministry of Health and Welfare: The Third Korea National Health & Nutrition Examination Survey (KNHANES III) 2005 - Nutrition Survey; 2006
  20. Schram MT, Trompet S, Kamper AM, de Craen AJ, Hofman A, Euser SM, Breteler MM, Westendorp RG. Serum calcium and cognitive function in old age. J Am Geriatr Soc 2007; 55(11): 1786-1792 https://doi.org/10.1111/j.1532-5415.2007.01418.x
  21. Gao S, Jin Y, Unverzagt FW, Ma F, Hall KS, Murrell JR, Cheng Y, Shen J, Ying B, Ji R, Matesan J, Liang C, Hendrie HC. Trace element levels and cognitive function in rural elderly Chinese. J Gerontol A Biol Sci Med Sci 2008; 63(6): 635-641 https://doi.org/10.1093/gerona/63.6.635
  22. Morris MC, Evans DA, Bienias JL, Scherr PA, Tangney CC, Hebert LE, Bennett DA, Wilson RS, Aggarwal N. Dietary niacin and the risk of incident Alzheimer's disease and of cognitive decline. J Neurol Neurosurg Psychiatry 2004; 75(8): 1093-1099 https://doi.org/10.1136/jnnp.2003.025858
  23. Azcoitia I, Moreno A, Carrero P, Palacios S, Garcia-Segura LM. Neuroprotective effects of soy phytoestrogens in the rat brain. Gynecol Endocrinol 2006; 22(2): 63-69 https://doi.org/10.1080/09513590500519161
  24. File SE, Hartley DE, Elsabagh S, Duffy R, Wiseman H. Cognitive improvement after 6 weeks of soy supplements in postmenopausal women is limited to frontal lobe function. Menopause 2005; 12(2): 193-201 https://doi.org/10.1097/00042192-200512020-00014
  25. Barranco Quintana JL, Allam MF, Serrano Del Castillo A, Fernandez-Crehue t Navajas R. Alzheimer's disease and coffee: a quantitative review. Neurol Res 2007; 29(1): 91-95 https://doi.org/10.1179/174313206X152546
  26. Van Gelder BM, Buijsse B, Tijhuis M, Kalmijn S, Giampaoli S, Nissinen A, Kromhout D. Coffee consumption is inversely associated with cognitive decline in elderly European men. Eur J Clin Nutr 2007; 61(2): 226-232 https://doi.org/10.1038/sj.ejcn.1602495
  27. Norman D, Bardwell WA, Loredo JS, Ancoli-Israel S, Heaton RK, Dimsdale JE. Caffeine intake is independently associated with neuropsychological perfor -mance in patients with obstructive sleep apnea. Sleep Breath 2008; 12(3): 199-205 https://doi.org/10.1007/s11325-007-0153-7
  28. Arendash GW, Schleif W, Rezai-Zadeh K, Jackson EK, Zacharia LC, Cracchiolo JR, Shippy D, Tan J. Caffeine protects Alzheimer's mice against cognitive impairment and reduces brain beta-amyloid production. Neuroscience 2006; 142(4): 941-952 https://doi.org/10.1016/j.neuroscience.2006.07.021
  29. Jiang Y, Noh SK, Koo SI. Egg phosphatidylcholine decreases the lymphatic absorption of cholesterol in rats. J Nutr 2001; 131(9): 2358-2363 https://doi.org/10.1093/jn/131.9.2358
  30. Fernstrom JD. Can nutrient supplements modify brain function? Am J Clin Nutr 2000; 71: 1669S-1673S https://doi.org/10.1093/ajcn/71.6.1669S