Psychiatria pre prax 6/2003

Disorders of nutrition in alzheimer‘S disease and options for therapeutic access

In severe stages, Alzheimer´s dementia is commonly associated not only with disturbances of nutritional intake determined directly by dementia, but also with dysregulations of intermediate metabolism with impact on organ functions, energetic metabolism, and metabolism of micronutrients. These changes deteriorate significantly nutritional state of the patient. Pathophysiological mechanisms seem to be specific to this type of dementia but the consequences stay still unexplained. The clinical therapeutic endpoint is based on early diagnosis of malnutrition followed by appropriate nutritional intervention which effectivelly limit development of malnutrition with loss of lean body mass and progress of invalidisation due to cachexia. Balanced oral intake and sipping are the elemental means of nutritional intervention in patients with dementia. Enteral nutrition and parenteral nutrition are indicated in severe states of malnutrition.

Keywords: dementia, Alzheimer disease, malnutrition, enteral nutrition, parenteral nutrition.