Nutritional status and dementia in oldest-old women

Summary the literature data about the relationships between dementia and nutritional indices in oldest-old people are scarce, we evaluated the nutritional and cognitive status of 27 non-hospitalized, over 90-year-old women living in Bologna. Among them, 15 subjects were demented according to the guidelines of the American Psychiatric Association (DSM-III-R). Body mass index (BMI) was calculated as weight/height (kg/m). Fat mass percentage (FM%) was calculated from anthropometric measurements according to the Durnin-Womersleyʹ formula. Serum albumin, vitamin D (1,25(OH)2D), and insulin-like-growth factor 1 (IGF-1) were also measured. No difference between demented and non demented people was found for BMI and serum albumin, whereas demented women had smaller values of FM%, 1,25(OH)2D and IGF-1. As demented women were also significantly older and less literate than normal women, the statistical significance of these differences was retested by ANOVA variance analysis adjusting for age and years of education. FM% (p = 0.017), 1,25(OH)2D (p = 0.004) and IGF-1 (p = 0.004) were all confirmed being significantly reduced in demented women. The conclusions are: (i) demented over 90-year-old women have an increased risk of mal-nutrition; (ii) although usually used in clinical routine, BMI and serum albumin seem to be less sensible nutritional indicators than the less commonly evaluated skinfold thicknesses, vitamin D and IGF-1.