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Front. Nutr. | doi: 10.3389/fnut.2018.00128

Association between Appetite and Sarcopenia in Patients with Mild Cognitive Impairment and Early-stage Alzheimer’s Disease

 Ai Kimura1, 2,  Taiki Sugimoto1, 3, 4, Shumpei Niida1, Kenji Toba1 and  Takashi Sakurai1, 2*
  • 1National Center for Geriatrics and Gerontology (NCGG), Japan
  • 2Nagoya University, Japan
  • 3Kobe University, Japan
  • 4Japan Society for the Promotion of Science (JSPS), Japan

Background: Sarcopenia is frequently seen in patients with mild cognitive impairment (MCI) and early-stage Alzheimer’s disease (AD). While appetite loss and physical inactivity, which are also frequently seen in dementia, appear to contribute to sarcopenia, to date, no study has investigated this association.
Objective: The aim of this study was to examine factors associated with sarcopenia, including appetite and physical activity, in patients with MCI and early-stage AD.
Methods: The study subjects comprised 205 outpatients (MCI, n = 151; early-stage AD, n = 54) who were being treated at the Memory Clinic, National Center for Geriatrics and Gerontology and had a Mini-Mental State Examination score of 21 or higher. All subjects were assessed for appetite by using the Council on Nutrition Appetite Questionnaire (CNAQ). Confounding variables assessed included physical activity, activities of daily living, mood, body mass index (BMI), nutritional status, and medications. Sarcopenia was defined as low muscle mass and low handgrip strength or slow gait speed. Multivariate logistic regression analyses were performed with adjustment for age, gender, education, and confounding variables to examine the association of sarcopenia with physical activity and appetite. Furthermore, sub-analyses were also conducted to clarify the relationship between CNAQ sub-items and sarcopenia.
Results: The prevalence of sarcopenia among the subjects was 14.6% (n = 30). Patients with sarcopenia had lower CNAQ scores (those with sarcopenia, 26.7 ± 3.5; those without, 29.1 ± 2.5). Multivariate analysis showed that BMI (odds ratio [OR], 0.675; 95% confidence interval [CI], 0.534–0.853), polypharmacy (OR, 4.489; 95% CI, 1.315–15.320), and CNAQ (OR, 0.774; 95% CI, 0.630–0.952) were shown to be associated with sarcopenia. Physical activity was not associated with sarcopenia. Of the sub-items of the CNAQ, appetite (OR, 0.353; 95% CI, 0.155–0.805), feeling full (OR, 0.320; 95% CI = 0.135–0.761), and food tastes compared to when younger (OR, 0.299; 95% CI, 0.109–0.818) were shown to be associated with sarcopenia.
Conclusions: These results suggest that appetite could be a modifiable risk factor for sarcopenia in patients with MCI and early-stage AD. A comprehensive approach to improving appetite may prove effective in preventing sarcopenia.

Keywords: Sarcopenia, Appetite, Mild Cognitive Impairment, early-stage Alzheimer’s disease, Gustatory function, satiety

Received: 14 Jul 2018; Accepted: 04 Dec 2018.

Edited by:

Akio Inui, Kagoshima University Graduate School of Medical and Dental Sciences, Japan

Reviewed by:

Takahiro A. Kato, Kyushu University, Japan
Keiko Mamiya, Shinshu University, Japan  

Copyright: © 2018 Kimura, Sugimoto, Niida, Toba and Sakurai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD, PhD. Takashi Sakurai, National Center for Geriatrics and Gerontology (NCGG), Ōbu, Japan,