OJMP  Vol.8 No.1 , January 2019
Association between Malnutrition and Cognitive Impairment among Morocco’s Older Adults
ABSTRACT
Objective: The aim of this study was to determine the association between the malnutrition and risk of cognitive impairment among Morocco older adults. Materials and methods: A sample of 237 older adults aged above 60 years were recruited from three nursing homes belonging to three different cities, Rabat, Kenitra and Sidi Kacem City and from one health center in Sidi Kacem City. From them, 172 subjects (56.4% men) were included in our study for their completion. Cognitive functions were assessed by the Mini-Mental State Examination. Nutritional status, depression and physical activity were assessed using respectively: MNA, GDS-15 and GPAQ. The binary logistic regression was performed where the cognitive function was taking as the dependent variable and all other outcomes as independent variables. Results: Our results showed that 69.8% of total simple were classed as having cognitive impairment while only 30.2% were normal. The binary logistic regression assessed showed that the malnutrition (OR = 3.03, 95% CI: 1.34 - 6.85), gender (OR = 2.22, 95% CI: 1.03 - 5.71) and low education (OR = 8.35, 95% CI: 1.32 - 52.83) were risk factors for cognitive impairment, when moderate level of physical activity (OR = 0.19, 95% CI: 0.06 - 0.54) was a protective factor compared to the limited level. Conclusions: Our study supported past literature that malnutrition and low level of physical activity were risk factors of cognitive impairment. These indicate that nutritional status monitoring and the practice of regular physical activities can prevent it from leading to Alzheimer’s disease.
Cite this paper
Talhaoui, A. , Aboussaleh, Y. , Ahami, A. , Sbaibi, R. and Agoutim, N. (2019) Association between Malnutrition and Cognitive Impairment among Morocco’s Older Adults. Open Journal of Medical Psychology, 8, 1-14. doi: 10.4236/ojmp.2019.81001.
References
[1]   HCP (2018) Les projections de la population et des ménages entre 2014 et 2050. Site institutionnel du Haut-Commissariat au Plan du Royaume du Maroc.
https://www.hcp.ma/Les-projections-de-la-population-et-des-menages-entre-2014-et-2050_a1920.html

[2]   de Jaeger, C. and Cherin, P. (2011) Les théories du vieillissement. Médecine & Longévité, 3, 155-174. https://doi.org/10.1016/j.mlong.2011.10.001

[3]   Malara, A., Sgrò, G., Caruso, C., Ceravolo, F., Curinga, G., Renda, G.F., Spadea, F., Garo, M. and Rispoli, V. (2014) Relationship between Cognitive Impairment and Nutritional Assessment on Functional Status in Calabrian Long-Term-Care. Clinical Interventions in Aging, 9, 105-110.

[4]   Shi, R., Duan, J., Deng, Y., Tu, Q., Cao, Y., Zhang, M., Zhu, Q. and Lü, Y. (2015) Nutritional Status of an Elderly Population in Southwest China: A Cross-Sectional Study Based on Comprehensive Geriatric Assessment. The Journal of Nutrition, Health & Aging, 19, 26-32. https://doi.org/10.1007/s12603-014-0471-y

[5]   van der Schueren, B., van Marian, A.E., Lonterman-Monasch, S., de Vries, O.J., Danner, S.A., Kramer, M.H.H. and Muller, M. (2013) Prevalence and Determinants for Malnutrition in Geriatric Outpatients. Clinical Nutrition, 32, 1007-1011.
https://doi.org/10.1016/j.clnu.2013.05.007

[6]   El Zoghbi, M., Boulos, C., Amal, A.H., Saleh, N., Awada, S., Rachidi, S., Bawab, W. and Salameh, P. (2013) Association between Cognitive Function and Nutritional Status in Elderly: A Cross-Sectional Study in Three Institutions of Beirut—Lebanon. Geriatric Mental Health Care, No. 4, 73-81.
https://doi.org/10.1016/j.gmhc.2013.04.007

[7]   Hirose, T., Hasegawa, J., Izawa, S., Enoki, H., Suzuki, Y. and Kuzuya, M. (2014) Accumulation of Geriatric Conditions Is Associated with Poor Nutritional Status in Dependent Older People Living in the Community and in Nursing Homes: Geriatric Conditions Associated with Malnutrition. Geriatrics & Gerontology International, 14, 198-205. https://doi.org/10.1111/ggi.12079

[8]   Raynaud-Simon, A., Revel-Delhom, C. and Hébuterne, X. (2011) Clinical Practice Guidelines from the French Health High Authority: Nutritional Support Strategy in Protein-Energy Malnutrition in the Elderly. Clinical Nutrition, 30, 312-319.
https://doi.org/10.1016/j.clnu.2010.12.003

[9]   Torres, M. (2014) Statut nutritionnel de la personne agée vivant à domicile: Prévalence, facteurs associés et conséquences. Université de Bordeaux, Phdthesis.

[10]   Laursen, P. (1997) The Impact of Aging on Cognitive Functions. An 11-Year Follow-up Study of Four Age Cohorts. Acta Neurologica Scandinavica. Supplementum, 172, 7-86.

[11]   Larrieu, S., Letenneur, L., Orgogozo, J.M., Fabrigoule, C., Amieva, H., Le Carret, N., Barberger-Gateau, P. and Dartigues, J.F. (2002) Incidence and Outcome of Mild Cognitive Impairment in a Population-Based Prospective Cohort. Neurology, 59, 1594-1599. https://doi.org/10.1212/01.WNL.0000034176.07159.F8

[12]   El Kadmiri, N., Hamzi, K., El Moutawakil, B., Slassi, I. and Nadifi, S. (2013) Les aspects génétiques de la maladie d’Alzheimer (Revue). Pathologie Biologie, 61, 228-238. https://doi.org/10.1016/j.patbio.2013.04.001

[13]   Perrin, R.J., Fagan, A.M. and Holtzman, D.M. (2009) Multimodal Techniques for Diagnosis and Prognosis of Alzheimer’s Disease. Nature, 461, 916-922.
https://doi.org/10.1038/nature08538

[14]   Guyant-Maréchal, L., Campion, D. and Hannequin, D. (2009) Génétique de la maladie d’Alzheimer: Formes autosomiques dominantes. Revue Neurologique, 165, 223-231. https://doi.org/10.1016/j.neurol.2008.10.019

[15]   Foubert-Samier, A. and Goizet, C. (2010) Génétique et maladie d’Alzheimer. Neurologie, 2, 194-196.

[16]   St. George-Hyslop, P. (1995) Genetic Determinants of Alzheimer Disease. Progress in Clinical and Biological Research, 393, 139-145.

[17]   Saunders, A.M., Strittmatter, W.J., Schmechel, D., St. George-Hyslop, P.H., Pericak-Vance, M.A., Joo, S.H., Rosi, B.L., et al. (1993) Association of Apolipoprotein E Allele 4 with Late-Onset Familial and Sporadic Alzheimer’s Disease. Neurology, 43, 1467-1467. https://doi.org/10.1212/WNL.43.8.1467

[18]   Lamour, Y. (1994) Physiopathologie de la maladie d’Alzheimer. La Revue de Médecine Interne, 15, 41s-44s.

[19]   Spaccavento, S., Del Prete, M., Craca, A. and Fiore, P. (2009) Influence of Nutritional Status on Cognitive, Functional and Neuropsychiatric Deficits in Alzheimer’s Disease. Archives of Gerontology and Geriatrics, 48, 356-360.
https://doi.org/10.1016/j.archger.2008.03.002

[20]   Solfrizzi, V., Panza, F., Frisardi, V., Seripa, D., Logroscino, G., Imbimbo, B.P. and Pilotto, A. (2011) Diet and Alzheimer’s Disease Risk Factors or Prevention: The Current Evidence. Expert Review of Neurotherapeutics, 11, 677-708.
https://doi.org/10.1586/ern.11.56

[21]   Anthony, J.C., Le Resche, L., Niaz, U., Von Korff, M.R. and Folstein, M.F. (1982) Limits of the “Mini-Mental State” as a Screening Test for Dementia and Delirium among Hospital Patients. Psychological Medicine, 12, 397.
https://doi.org/10.1017/S0033291700046730

[22]   Derouesné, C., Poitreneau, J., Hugonot, L., Kalafat, M., Dubois, B. and Laurent, B. (1999) Le Mini-Mental State Examination (MMSE): Un outil pratique pour l’évaluation de l’état cognitif des patients par le clinician. 8.

[23]   Li, Y., Fang, X., Zhao, W.-G., Chen, Y. and Hu, S.-L. (2017) A Risk Factor Analysis of Cognitive Impairment in Elderly Patients with Chronic Diseases in a Chinese Population. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 23, 4549-4558. https://doi.org/10.12659/MSM.904254

[24]   Hai, S., Cao, L., Yang, X., Wang, H., Liu, P., Hao, Q.K. and Dong, B.R. (2017) Association between Nutrition Status and Cognitive Impairment among Chinese Nonagenarians and Centenarians. International Journal of Gerontology, 11, 215-219.
https://doi.org/10.1016/j.ijge.2016.12.002

[25]   Guigoz, Y., Vellas, B. and Garry, P.J. (1996) Assessing the Nutritional Status of the Elderly: The Mini Nutritional Assessment as Part of the Geriatric Evaluation. Nutrition Reviews, 54, S59-S65. https://doi.org/10.1111/j.1753-4887.1996.tb03793.x

[26]   Kondrup, J. (2003) ESPEN Guidelines for Nutrition Screening 2002. Clinical Nutrition, 22, 415-421. https://doi.org/10.1016/S0261-5614(03)00098-0

[27]   Guigoz, Y., Vellas, B. and Garry, P.J. (1997) Facts, Research and Intervention in Gerontology. In: The Mini Nutritional Assessment: A Practical Assessment Tool for Grading the Nutritional State of Elderly Persons, 3rd Edition, Serdi Publishing Company, Paris, 15-60.

[28]   Kurkcu, M., Meijer, R.I., Lonterman, S., Muller, M. and de van der Schueren, M.A.E. (2018) The Association between Nutritional Status and Frailty Characteristics among Geriatric Outpatients. Clinical Nutrition ESPEN, 23, 112-116.
https://doi.org/10.1016/j.clnesp.2017.11.006

[29]   Armstrong, T. and Bull, F. (2006) Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). Journal of Public Health, 14, 66-70. https://doi.org/10.1007/s10389-006-0024-x

[30]   Bae, S., Shimada, H., Park, H., Lee, S., Makizako, H., Doi, T., Yoshida, D., Tsutsumimoto, K., Anan, Y. and Suzuki, T. (2017) Association between Body Composition Parameters and Risk of Mild Cognitive Impairment in Older Japanese Adults: Body Composition and MCI. Geriatrics & Gerontology International, 17, 2053-2059.
https://doi.org/10.1111/ggi.13018

[31]   Hamrik, Z., Sigmundová, D., Kalman, M., Pavelka, J. and Sigmund, E. (2014) Physical Activity and Sedentary Behaviour in Czech Adults: Results from the GPAQ Study. European Journal of Sport Science, 14, 193-198.
https://doi.org/10.1080/17461391.2013.822565

[32]   Muscari, A., Spiller, I., Bianchi, G., Fabbri, E., Forti, P., Magalotti, D., Pandolfi, P. and Zoli, M. (2018) Predictors of Cognitive Impairment Assessed by Mini Mental State Examination in Community-Dwelling Older Adults: Relevance of the Step Test. Experimental Gerontology, 108, 69-76.
https://doi.org/10.1016/j.exger.2018.03.021

[33]   Noh, H.-M., Oh, S., Song, H.J., Lee, E.Y., Jeong, J.-Y., Ryu, O.-H., Hong, K.-S. and Kim, D.-H. (2017) Relationships between Cognitive Function and Body Composition among Community-Dwelling Older Adults: A Cross-Sectional Study. BMC Geriatrics, 17, 259. https://doi.org/10.1186/s12877-017-0651-9

[34]   Saghafi-Asl, M. and Vaghef-Mehrabany, E. (2017) Comprehensive Comparison of Malnutrition and Its Associated Factors between Nursing Home and Community Dwelling Elderly: A Case-Control Study from Northwestern Iran. Clinical Nutrition ESPEN, 21, 51-58. https://doi.org/10.1016/j.clnesp.2017.05.005

[35]   McGee, M. and Jensen, G.L. (2000) Nutrition in the Elderly. Journal of Clinical Gastroenterology, 30, 372-380. https://doi.org/10.1097/00004836-200006000-00005

[36]   Sjögren, A., Österberg, T. and Steen, B. (1994) Intake of Energy, Nutrients and Food Items in a Ten-Year Cohort Comparison and in a Six-Year Longitudinal Perspective: A Population Study of 70- and 76-Year-Old Swedish People. Age and Ageing, 23, 108-112. https://doi.org/10.1093/ageing/23.2.108

[37]   O’Brien, J.S. and Lois Sampson, E. (1965) Lipid Composition of the Normal Human Brain: Gray Matter, White Matter, and Myelin. Journal of Lipid Research, 6, 537-544.

[38]   Solfrizzi, V., Panza, F., Torres, F., Mastroianni, F., Del Parigi, A., Venezia, A. and Capurso, A (1999) High Monounsaturated Fatty Acids Intake Protects against Age-Related Cognitive Decline. Neurology, 52, 1563-1569.
https://doi.org/10.1212/WNL.52.8.1563

[39]   Naqvi, A.Z., Harty, B., Mukamal, K.J., Stoddard, A.M., Vitolins, M. and Dunn, J.E. (2011) Monounsaturated, Trans & Saturated Fatty Acids and Cognitive Decline in Women. Journal of the American Geriatrics Society, 59, 837-843.
https://doi.org/10.1111/j.1532-5415.2011.03402.x

[40]   Baierle, M., Vencato, P., Oldenburg, L., Bordignon, S., Zibetti, M., Trentini, C., Duarte, M., et al. (2014) Fatty Acid Status and Its Relationship to Cognitive Decline and Homocysteine Levels in the Elderly. Nutrients, 6, 3624-3640.
https://doi.org/10.3390/nu6093624

[41]   Bo, Y.C., Zhang, X.Y., Wang, Y.L., You, J., Cui, H., Zhu, Y.W., Pang, W., Liu, W., Jiang, Y.G. and Lu, Q.J. (2017) The N-3 Polyunsaturated Fatty Acids Supplementation Improved the Cognitive Function in the Chinese Elderly with Mild Cognitive Impairment: A Double-Blind Randomized Controlled Trial. Nutrients, 9, 54.
https://doi.org/10.3390/nu9010054

[42]   Bélanger, M., Allaman, I. and Magistretti, P.J. (2011) Brain Energy Metabolism: Focus on Astrocyte-Neuron Metabolic Cooperation. Cell Metabolism, 14, 724-738.
https://doi.org/10.1016/j.cmet.2011.08.016

[43]   Morris, M.C., Evans, D.A., Bienias, J.L., Tangney, C.C. and Wilson, R.S. (2002) Vitamin E and Cognitive Decline in Older Persons. Archives of Neurology, 59, 1125-1132. https://doi.org/10.1001/archneur.59.7.1125

[44]   Oyarce, K., Bongarzone, E.R. and Nualart, F. (2014) Unconventional Neurogenic Niches and Neurogenesis Modulation by Vitamins. Journal of Stem Cell Research & Therapy, 4, 184.

[45]   Mandolesi, L., Polverino, A., Montuori, S., Foti, F., Ferraioli, G., Sorrentino, P. and Sorrentino, G. (2018) Effects of Physical Exercise on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits. Frontiers in Psychology, 9, 509.
https://doi.org/10.3389/fpsyg.2018.00509

[46]   Lochbaum, M.R., Karoly, P. and Landers, D.M. (2002) Evidence for the Importance of Openness to Experience on Performance of a Fluid Intelligence Task by Physically Active and Inactive Participants. Research Quarterly for Exercise and Sport, 73, 437-444. https://doi.org/10.1080/02701367.2002.10609043

 
 
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