營養攝取與認知功能正常、輕度知能障礙及失智症相關性之探討

Exploring the Relationships of Nutrient Intakes among Normal Cognitive Function, Mild Cognitive Impairment and Dementia

鄭貴月(Kuei-Yueh Cheng)

指導教授 ： 高月慈

義守大學/醫學院/醫務管理學系/碩士(2017年)

摘要

研究背景 全球失智症人口快速增加，推估2015年將有990萬新增失智症案例，而適當的營養對於記憶功能的維持扮演重要的角色。長久以來，就有不少研究在探討飲食與失智症的相關性，包括食物種類與得病的相關性，及以飲食型態來預防或延緩疾病惡化。目前國內較少針對失智症患者的飲食攝取情形做研究，故本研究希望可以藉此找出輕度知能障礙（MCI）與已罹患失智症，在熱量與各種營養素攝取情形之差異。

研究方法 本研究為橫斷式相關性研究，選取南部某醫學中心經神經內科醫師診斷認知功能正常、MCI和失智症患者為研究對象，共訪談了128位符合條件的受試者，實際有效樣本數為124位。本研究將回收之有效樣本以敘述性統計、卡方檢定、變異數分析、皮爾森相關係數檢定及薛費氏事後檢定等統計方法進行資料分析。

研究結果 研究結果顯示：(一) 124位受試者 (正常組39位、MCI組43位、失智組42位) 的平均年齡約72歲，無運動習慣者、有高血壓及糖尿病病史，較易罹患失智症。 (二) 飲食型態方面：不管是飲食類型、每日正餐次數、有無吃點心或宵夜習慣、餐食準備、進食能力、牙齒功能及外食次數，雖在三組間沒有顯著性差異，但本研究對象中有牙齒功能不良者約40%，進而影響其進食功能。(三) 營養狀況方面：MCI組及失智組皆有營養不良之風險；另外，失智症患者在攝取卡路里、碳水化合物、膳食纖維及鉀的飲食中略顯不足。(四) 迷你營養評估量表 (MNA) 得分與研究對象基本屬性之相關性，結果發現：年齡愈大，其營養狀況愈差；教育愈高、攝取卡路里愈多、身體質量指數 (BMI) 及智能篩檢測驗 (CASI) 的得分愈高，其營養狀況愈好。

結論 透過本研究得知，有無運動習慣、罹患高血壓及糖尿病、營養狀況及部份營養素與失智症具有相關聯性。就以健康促進和預防醫學角度的觀點而言，應教育民眾，尤其為高危險群患者，定期檢測血壓、血糖等，並遵行有益的健康運動行為、多食用蔬果及牙齒功能檢測，早期預防失智症的發生，以降低疾病的風險。

關鍵字

輕度知能障礙 ； 迷你營養評估量表 ； 智能篩檢測驗 ； 營養攝取 ； 失智症

並列摘要

Background: As the rapid increase number of patient with dementia in the global population, suggesting that there will be 9.9 million new cases of dementia in 2015. Appropriate nutrition for the maintenance of memory function plays an important role. For a long time, there have been many studies to explore the relevance of diet and dementia, including the relationship between food types and sickness, and to prevent or delay disease progression in different dietary patterns. At present, there is little research on the dietary intake of patients with dementia, so this study hopes to find out the difference caloric and nutrient intake in mild cognitive impairment (MCI) and those with dementia.

Method: This is a cross-sectional study from a medical center in the south Taiwan. Normal control and subjects under diagnosis of mild cognitive impairment and dementia were enrolled by neurologist. We totally interviewed 128 eligible subjects, the actual number of valid samples is 124 subjects. In this study, the valid samples were analyzed by statistical methods such as descriptive statistics, chi-square test, variance analysis, Pearson correlation coefficient test and post-hoc test.

Results: The results of the study showed that: (1) There were totally 124 subjects (39 normal control group, 43 MCI group and 42 dementia group) had an average age of 72 years. Those without exercise habits, history of hypertension and diabetes mellitus, are more susceptible to dementia. (2) There was no significant difference between the three groups including dietary patterns included type of diet, the number of daily meals, whether to eat snacks or supper habits, food preparation, eating ability and the number of external food. Subjects with dental dysfunction of about 40% in the study, and thereby affecting its eating function. (3) MCI group and the dementia group are at risk of malnutrition; In addition, the intake of calories, carbohydrates, dietary fiber and potassium diet have some problem in patients with dementia. (4) The correlation between the Mini Nutritional Assessment (MNA) score revealed that the study object with older age had worse nutritional status; those with higher education, the higher calorie intake, the higher the body mass index (BMI) and Cognitive Abilities Screening Instrument (CASI) Nutritional status had better nutrition status.

Conclusion: Through this study, we found that the presence of exercise habits, hypertension

and diabetes, nutritional status and some nutrients are correlated with dementia. In view of the health promotion and preventive medicine, we should educate the public, especially those with high-risk about regular check blood pressure and blood sugar, etc., follow the beneficial health exercise behavior, eat more vegetable and fruits and teeth functional testing for dementia prevention and reduce the risk of dementia.

並列關鍵字

Mild Cognitive Impairment ； Mini Nutritional Assessment ； Cognitive Abilities Screening Instrument ； Nutrient Intakes ； Dementia

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