. Accelerated Weight Loss May Precede Diagnosis in Alzheimer Disease. Arch Neurol. 2006 Sep 1;63(13):12-17.

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  1. This paper from colleagues from Washington University School of Medicine, St. Louis, reports interesting data showing that accelerated weight loss may precede diagnosis of Alzheimer disease. Data are based on a longitudinal study with follow-up time of 6 years in a cohort of 449 elderly non-demented subjects. During the follow-up time, 125 individuals developed dementia of Alzheimer type (DAT), and the other 324 subjects remained without dementia. While participants without dementia lost about 0.6 lb/year, the rate of weight loss was doubled in subjects who developed dementia (1.2 lb/year).

    It is well-known that aging is associated with mild weight loss and that unintentional weight loss may be a mark of disease. In Alzheimer disease (AD), particularly in advanced stages, weight loss is evident. This study now provides data showing that weight loss may precede diagnosis of AD. It was notable that other health risks investigated, such as depressive symptoms, marital status, use of potentially anorectic medications, ApoE ε4 allele, diabetes, or appetite change were not related to weight loss.

    It is interesting to note that in another study by Vanhanen et al. (2001) the authors measured weight and body mass index (BMI) at an interval of 3.5 years and also determined ApoE phenotype in an elderly population (N = 980), including 46 patients with AD and 911 control subjects at the end of the follow-up. The average weight loss in patients carrying the ApoE ε4 allele was 1.9 ± 4.0 kg, whereas ε4 non-carriers gained weight (1.2 ± 3.8 kg; p On the other hand, there are data suggesting that obesity at midlife is a risk factor for AD at late life (Kivipelto et al., 2005).

    The data concerning weight changes in the preclinical stage of AD are interesting and more studies are also needed to investigate the causes of weight loss.

    References:

    . APOE-epsilon4 is associated with weight loss in women with AD: a population-based study. Neurology. 2001 Mar 13;56(5):655-9. PubMed.

    . Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Arch Neurol. 2005 Oct;62(10):1556-60. PubMed.

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