* Department of Internal medicine and Clinical Gerontology, Hôpital la Grave-Casselardit, Toulouse, France. ** INSERM U 518, Toulouse, France. *** Programa Vida Als Anys. Servei Català de la Salut. Barcelona. / Hospital Sant Jaume, Mataro. Spain. **** Laboratory of Epidemiology & Neuroimaging, IRCCS San Giovanni di Dio, Brescia, Italy. Correspondence: Bruno Vellas, Department of Internal medicine and Clinical Gerontology, Hôpital la Grave-Casselardit, 170 avenue de Casselardit, 31300 Toulouse, France. Fax : 33 (0)5 61 77 25 93.
E-mail dintilhac.b@chu-toulouse.fr

Abstract: Background Weight loss is a common problem in patients with Alzheimer's Disease (AD). It is a predictive factor of mortality and it decreases patients' and caregivers' quality of life. Objective To determine if a nutritional education program can prevent weight loss in AD patients. Subjects 151 AD patients and their caregivers were enrolled to follow the intervention and 74 AD patients and their caregivers constituted a control group. Method Caregivers in the intervention group followed 9 nutritional sessions of one hour each, over one year. Caregivers in the control group didn't follow any sessions but were offered advice provided in a normal follow-up. Patients weight, nutritional state, cognitive function, autonomy, mood, behaviour disorders at baseline and at 6- and 12-month follow-up. Caregivers burden, nutritional and AD knowledge at the baseline and at the 12-month follow-up. Results During the year follow-up, the mean weight increased in the intervention group (0.7±3.6 kg) whereas it decreased in the control group (-0.7±5.4 kg) (p<0.05). The nutritional status (MNA) was maintained in the intervention group (0.3±2.6) whereas it decreased significantly in the control group (-1.0±3.4) (p<0.005). After adjustment for baseline differences between the two groups (caregiver age, nutritional state, eating behaviour disorders, depression), the weight change between the two groups was not significant (0.6±0.4 kg vs. -0.6±0. 6kg respectively in intervention group and control group). However, the percentage of patients with significant weight loss is decreased. The MMSE change became significant between the two groups: -2.3±0.3 vs. -3.4±0.4 respectively in intervention group and control group (p<0.05). Conclusions These results suggest that a nutritional educational program intended for caregivers of AD patients could have a positive effect on patients weight and cognitive function.

Keywords : Nutrition, Alzheimer, intervention, weight loss, education.