Research Article: Nutritional status and body composition by bioelectrical impedance vector analysis: A cross sectional study in mild cognitive impairment and Alzheimer’s disease

Date Published: February 10, 2017

Publisher: Public Library of Science

Author(s): Ilaria Cova, Simone Pomati, Laura Maggiore, Marica Forcella, Valentina Cucumo, Roberta Ghiretti, Giulia Grande, Fulvio Muzio, Claudio Mariani, Sonia Brucki.


Analysis of nutritional status and body composition in Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI).

A cross-sectional study was performed in a University-Hospital setting, recruiting 59 patients with AD, 34 subjects with MCI and 58 elderly healthy controls (HC). Nutritional status was assessed by anthropometric parameters (body mass index; calf, upper arm and waist circumferences), Mini Nutritional Assessment (MNA) and body composition by bioelectrical impedance vector analysis (BIVA). Variables were analyzed by analysis of variance and subjects were grouped by cognitive status and gender.

Sociodemographic variables did not differ among the three groups (AD, MCI and HC), except for females’ age, which was therefore used as covariate in a general linear multivariate model. MNA score was significantly lower in AD patients than in HC; MCI subjects achieved intermediate scores. AD patients (both sexes) had significantly (p<0.05) higher height-normalized impedance values and lower phase angles (body cell mass) compared with HC; a higher ratio of impedance to height was found in men with MCI with respect to HC. With BIVA method, MCI subjects showed a significant displacement on the RXc graph on the right side indicating lower soft tissues (Hotelling’s T2 test: men = 10.6; women = 7.9;p < 0,05) just like AD patients (Hotelling’s T2 test: men = 18.2; women = 16.9; p<0,001). Bioelectrical parameters significantly differ from MCI and AD to HC; MCI showed an intermediate pattern between AD and HC. Longitudinal studies are required to investigate if BIVA could reflect early AD-changes in body composition in subjects with MCI.

Partial Text

Due to global population aging, dementia and particularly Alzheimer’s dementia (AD) are becoming a public health priority. The greatest risk factor for AD is a heterogeneous prognostic condition recognized as Mild Cognitive Impairment (MCI)[1]. Research efforts have been focusing on the identification of predictive factors of progression from MCI to AD.

Tables 1 and 2 show psycho-functional, anthropometric, multidimensional and bioelectrical variables in healthy controls (HC), Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD), respectively in men and in women.

According to our results, patients with AD showed a significantly different nutritional status with respect to cognitively healthy controls. Anthropometric measurements, more precisely calf and arm circumferences, were significantly lower in AD patients in both sexes; waist circumferences resulted significantly lower in men with AD than in controls. Patients with AD (both sexes) achieved lower score at MNA. Worse nutritional indicators at BIVA were found in AD patients with respect to controls: bioelectrical vectors were characterized by lower phase angles, higher height-normalized impedance values and a different pattern of impedance vector migration with displacement on the right side of the confidence ellipses of AD patients with respect of controls. MCI subjects did not differ from controls in anthropometric measures and in nutritional assessment by MNA except for screening score in men group. According to BIVA, men with MCI showed higher impedance vectors (normalized for height) and significantly different patterns of impedance vector migration were found in MCI of both sexes with respect to controls.




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