Análisis longitudinal de parámetros nutricionales en una cohorte de ancianos con y sin demencia / Longitudinal analysis of nutrition parameters in a cohort of elderly people with and without dementia

Introducción. La evaluación nutricional longitudinal, debido a sus frecuentes alteraciones, es especialmente relevante en al anciano con deterioro cognitivo. El objetivo del presente estudio es valorar a lo largo del tiempo el efecto y la posible interacción del deterioro cognitivo y del envejecimiento en los parámetros nutricionales. Material y métodos. Estudio longitudinal prospectivo de 2 años de seguimiento en 301 ancianos (233 mujeres y 68 varones) en el medio residencial, 51 de los cuales tienen criterios de demencia. Los parámetros antropométricos y bioquímicos se obtuvieron según técnicas normalizadas. Resultados. Los ancianos con demencia presentan, en todos los parámetros estudiados, valores inferiores respecto a los ancianos sin demencia. En los pacientes con deterioro cognitivo los valores medios de los parámetros nutricionales permanecen estables y sin diferencias significativas tras 2 años de seguimiento: índice de masa corporal 24,5 ± 4,9 vs 24,2 ± 4,1; pliegue tricipital 15,0 ± 6,0 vs 14,7 ± 6,9; circunferencia braquial 25,9 ± 3,3 vs 25,7 ± 3,5, y albúmina 3,7 ± 0,3 vs 3,7 ± 0,3. En los pacientes sin deterioro cognitivo los valores al final del estudio han descendido respecto a los valores basales, excepto el pliegue bicipital y los triglicéridos. Conclusiones. Tras 2 años de seguimiento no se observa descenso de los parámetros nutricionales estudiados en los ancianos con demencia; sin embargo, sí aparece un descenso en los ancianos sin deterioro cognitivo. Las causas de estas diferencias pueden ser múltiples. Son necesarios más estudios, con mayor número de ancianos y un mayor periodo de seguimiento, para validar estos hallazgos (AU)

Introduction. It is important to assess longitudinal nutritional parameters during the ageing process in order to determine body composition changes. This procedure is more relevant when dealing with institutionalised geriatric patients suffering from cognitive impairment. The aim of this study was to assess the interactions, if any, between mental status and several nutritional parameters in a cohort of elderly people. Material and methods. A longitudinal prospective two years follow-up evaluation was performed on 301 elderly residents (233 females and 68 males) in a nursing home, of whom 51 of them fulfilled the clinical criteria for dementia. Both anthropometric and biochemical parameters were obtained annually, according to standard procedures. Results. The dementia group had lower values when compared to the non-dementia group. Furthermore, nutritional values remained constant in the group with cognitive impairment (no significant differences were observed throughout the study period). BMI 24.5 ± 4.9 vs 24.2 ± 4.1; tricipital skinfold 15.0 ± 6.0 vs 14.7 ± 6.9; brachial circumference 25.9 ± 3.3 vs 25.7 ± 3.5, and albumin 3.7 ± 0.3 vs 3.7 ± 0.3. At the end of the study, the group without cognitive impairment showed lower values in all the parameters analysed when compared to the baseline ones, except for bicipital fold and plasma triglycerides. Conclusions. Our study shows that there are no variations in the elderly with cognitive impairment, as regards the nutritional, anthropometric and biochemist parameters analysed. On the contrary, the group with normal cognitive status showed a reduction in most of the parameters. Further studies analysing larger populations of elderly people and over longer periods of time will provide more information to improve our knowledge on this important issue (AU)

[Longitudinal analysis of nutrition parameters in a cohort of elderly people with and without dementia]. / Análisis longitudinal de parámetros nutricionales en una cohorte de ancianos con y sin demencia.

INTRODUCTION: It is important to assess longitudinal nutritional parameters during the ageing process in order to determine body composition changes. This procedure is more relevant when dealing with institutionalised geriatric patients suffering from cognitive impairment. The aim of this study was to assess the interactions, if any, between mental status and several nutritional parameters in a cohort of elderly people. MATERIAL AND METHODS: A longitudinal prospective two years follow-up evaluation was performed on 301 elderly residents (233 females and 68 males) in a nursing home, of whom 51 of them fulfilled the clinical criteria for dementia. Both anthropometric and biochemical parameters were obtained annually, according to standard procedures. RESULTS: The dementia group had lower values when compared to the non-dementia group. Furthermore, nutritional values remained constant in the group with cognitive impairment (no significant differences were observed throughout the study period). BMI 24.5±4.9 vs 24.2±4.1; tricipital skinfold 15.0±6.0 vs 14.7±6.9; brachial circumference 25.9±3.3 vs 25.7±3.5, and albumin 3.7±0.3 vs 3.7±0.3. At the end of the study, the group without cognitive impairment showed lower values in all the parameters analysed when compared to the baseline ones, except for bicipital fold and plasma triglycerides. CONCLUSIONS: Our study shows that there are no variations in the elderly with cognitive impairment, as regards the nutritional, anthropometric and biochemist parameters analysed. On the contrary, the group with normal cognitive status showed a reduction in most of the parameters. Further studies analysing larger populations of elderly people and over longer periods of time will provide more information to improve our knowledge on this important issue.

Rhabdomyolysis and drug abuse in a patient with bulimia nervosa.

OBJECTIVE: Eating disorders, particularly bulimia nervosa, have long been associated with alcohol and illicit drug abuse. Impulsivity has been linked to substance abuse, but there are other explanations for this association. This comorbidity could be very harmful, even deadly, because of the medical consequences of drug abuse. METHOD: This article reports on the case of a 23-year-old woman with bulimia nervosa, severe alcohol and illicit drug abuse, and impulsive behavior who developed rhabdomyolysis. One of the reasons for her drug addiction was the effect of these substances in appetite suppression. RESULTS: The patient successfully recovered after medical and psychological treatment. CONCLUSION: This article presents the case of a patient with bulimia nervosa and a serious medical complication of illicit drug abuse. It is important to be aware of the increased risk of morbidity and mortality for this patient group.

Nutrición parenteral y cuidados paliativos / Parenteral nutrition and palliative care

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