Nutritional Status of Alzheimer’s Patients in a Geriatric Clinic in Dakar: A 10-Month Prospective Descriptive Study

iBackground: /iMalnutrition refers to a state of nutritional imbalance in the body. It is characterized by a negative energy and/or protein balance. Malnutrition is common in patients with dementia, particularly Alzheimers disease. Epidemiological data show that weight loss appears to increase as the disease progresses. It is thought to be a predictor of mortality in patients with Alzheimers disease because it is accompanied by severe events. The study of malnutrition in patients with Alzheimers disease appears to be essential. Few studies have focused on the relationship between nutritional status and cognitive status. In Senegal, only one study has looked at Alzheimers disease (AD) in the elderly, and the nutritional status of patients was not specifically assessed. We therefore decided to conduct this pioneering study in the geriatric population with AD in Senegal, with the primary objective of describing the epidemiological, clinical, paraclinical, and therapeutic aspects of malnutrition in our patients with AD in the geriatrics and gerontology department of the Fann National University Hospital Center in Dakar. iMethods: /iThis was a prospective, descriptive study conducted over a 10-month period from December 2022 to October 2023, involving patients aged 60 and over who were seen for an initial consultation in the geriatric department of the FANN University Hospital Center. Cognitive assessment was performed using the Senegal test, and malnutrition was screened for in these patients using the MNA. Epidemiological, clinical, paraclinical, and therapeutic characteristics were collected and analyzed using epi.info.7 software. iResults: /iOf the 695 patients seen during this period, thirty-two (32) had Alzheimers disease, representing a prevalence of 4.6%. The average age of our patients was 77+/-08 years (ranging from 6 to 92 years). The 75-79 age group (31.25%) was the most representative, followed by the 70-74 age group (21.88%). There was a predominance of women (68.75%), with a male/female ratio of 0.45. The main comorbidities were high blood pressure (62.65%) and diabetes (34.38%). The history of the disease was dominated by falls (15.63%). The main reason for consultation was memory disorders (100%). The duration of the disease was between 6 months and 1 year in 40.6% of patients. The Senegal test was the diagnostic tool used to screen for Alzheimers disease. Cognitive impairment according to the Senegal test appeared severe in 7 patients (21.87%), moderate in 4 patients (12.5%), and mild in 21 patients (65.63%). Geriatric syndromes were dominated by frailty (56.25%) and loss of functional independence (43.75%). Twelve patients (37.5%) were malnourished (MNA score below 17), 17 patients (53.12%) were at risk of malnutrition (MNA score between 17 and 23.5), and three patients were not malnourished (MNA score greater than or equal to 24). None of our patients were able to undergo testing for tau, phosphorylated tau, and β-amyloid proteins. The most common biological abnormalities were anemia (89.28%), followed by hypoalbuminemia (81.28%). Brain MRI performed on all our patients revealed hippocampal atrophy. The severity of the atrophy was specified in only 19 patients. The atrophy was grade 2 in 9 patients (28.13%), grade 3 in 3 patients (9.37%), grade 4 in 7 patients (21.87%), and unspecified in 13 patients (40.62%). Anticholinesterase inhibitors were the drug treatment of choice in our series, with 62.62% of patients receiving them. 37.38% received memantine. iConclusion: /iAD almost always progresses to malnutrition. It is important to screen for malnutrition systematically and early in order to develop care plans.