Weight Loss in Elderly May Be Sign of Neurologic Decline: Patients with Mild Cognitive Impairment

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ALBUQUERQUE -- Weight loss in an elderly person with mild cognitive impairment could be a surrogate for neurologic deterioration, Dr. Michael Grundman said.

Imaging studies performed by Dr. Grundman and his colleagues showed a relationship between low body mass index (BMI) and loss of volume in the mesial temporal cortex, which governs cognitive functions like learning, memory, and affect, as well as sleep, aggression, and appetite.

If these results are confirmed, helping these patients maintain their body weight may prevent or delay further cognitive decline, Dr. Grundman said at the annual meeting of the International Academy of Nutrition and Aging.

The mesial temporal cortex includes the hippocampus, the amygdala, and parahippocampal gyrus, which are among the first sites in the brain to reflect the pathology of Alzheimer's disease, Dr. Grundman explained. The hippocampus in particular is involved with learning, emotion, and memory.

To see if there might be a link between low body weight and mesial temporal atrophy in patients with Alzheimer's disease, he and his colleagues at the University of California, San Diego, compared MRI scans taken from 58 people with Alzheimer's disease with similar images taken of 16 control subjects matched for age, sex, and years of education. The Alzheimer's patients had significant brain atrophy in all of the regions studied, except the white matter. The correlation coefficient between mesial temporal volume and low BMI in me patients was 0.39, a statistically significant finding. None of the other brain regions studied showed a correlation with BMI.

The investigators also observed a correlation between mesial temporal cortical volume and scores on the dementia rating scale, suggesting a relationship between hippocampal volume and cognitive loss, and they were able to predict a patient's BMI by examining the MRI of his or her mesial temporal cortex. …


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