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What Studies Shows About Weight Loss and Dementia
From the earliest stages of AD, many people tend to lose weight, despite the best efforts of caregivers to provide high-calorie, nutrient-rich meals and snacks, and to remind the person to eat regularly. Some people with AD also advance to a condition known as cachexia, a general wasting effect that involves unexplained weight loss, as well as fatigue, weakness, and significant loss of appetite. Refernces: NIH 2007 Hope
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The underlying cause or causes of weight loss and cachexia associated with AD remain unclear, however. Some scientists have suggested that abnormally high daily calorie use (from pacing, for example), combined with lower-than-normal daily calorie intake, results in the drop in body mass. Others hypothesize that weight loss results from loss of the initiative to eat; loss of the sense of smell; or atrophy or other changes in the brain that alter the person's metabolism, appetite, or behavior.
While decreased body mass is a well-accepted part of AD, recent studies funded by the NIA also suggest that unexplained weight loss actually precedes the measurable cognitive impairment and other signs of the disease often by years. For example:
"Unexplained weight loss is well-recognized as part of the clinical constellation of Alzheimer's disease symptoms. Now, a growing body of evidence suggests that weight loss can actually begin before the signs of cognitive dysfunction appear," says Marcelle Morrison-Bogorad, PhD, director of the NIA's Neuroscience and Neuropsychology of Aging Program. "The jury is still out on whether weight loss is part of or a result of the Alzheimer's disease process, but these findings do suggest that even subtle decreases in weight might be a clinical predictor of AD."
Buchman, A.S. et al. (2005). Change in Body Mass Index and Risk of Incident Alzheimer Disease. Neurology, 65(6);892-7.
Johnson, D.K. et al. (2006). Accelerated Weight Loss May Precede Diagnosis in Alzheimer Disease. Archives of Neurology, 63(9):1312-7.
Knopman, D.S. et al. (2006). Incident Dementia in Women Preceded by Weight Loss by at Least a Decade (presented at the 10th International Conference on Alzheimer's Disease and Related Disorders; Abstract P1-207).
Stewart, R. et al. (2005). 32-Year Prospective Study of Change in Body Weight and Incident Dementia: The Honolulu-Asia Aging Study. Archives of Neurology, 62(1):55-60.
Refernces: NIH 2007
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