- Malnutrition prevalent: 25.7% malnourished, 60.0% at risk, 14.3% normal nutrition.
- Worse nutritional status associated with lower ACE-III cognitive scores and higher GDS depression scores; RBD and urinary incontinence differed by nutritional group.
- Age and female sex independently predicted poorer nutrition; cluster analysis identified a high-risk phenotype combining cognitive, mood, autonomic, and sleep burden.
Nutr Clin Pract. 2026 Jun 21. doi: 10.1002/ncp.70143. Online ahead of print.
ABSTRACT
BACKGROUND: Dementia with Lewy bodies (DLB) is a multisystem neurodegenerative disorder often accompanied by autonomic and neuropsychiatric symptoms. Nutritional impairment is increasingly recognized yet under-characterized in DLB. DLB was chosen due to its early multisystem involvement, including brainstem-mediated autonomic and sleep disturbances, which may uniquely affect nutrition. This study evaluated nutritional status and its associations with cognitive, mood, autonomic, and sleep-related features.
METHODS: Seventy patients with probable DLB (2017 McKeith criteria) were retrospectively included. Cases of Parkinson’s disease dementia or other Lewy body-related conditions were excluded. Nutritional status was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF). Cognitive function (Addenbrooke’s Cognitive Examination, ACE-III), depressive symptoms (Geriatric Depression Scale, GDS), motor severity (Hoehn and Yahr staging), sleep disturbances (Rapid Eye Movement Sleep Behavior Disorder, RBD, insomnia), and autonomic symptoms (urinary incontinence, constipation, orthostatic hypotension) were extracted from clinical records. Multivariable logistic, ordinal regression, and hierarchical cluster analyses were performed.
RESULTS: Normal nutrition was observed in 14.3% of patients, 60.0% were at risk, and 25.7% were malnourished. Malnutrition was significantly associated with lower ACE-III and higher GDS scores (p < 0.05). RBD and urinary incontinence differed across nutritional groups. Ordinal regression showed age and female sex independently associated with worse nutritional status. Cluster analysis identified a high-risk phenotype with greater cognitive, depressive, autonomic, and sleep-related burden linked to malnutrition.
CONCLUSION: Malnutrition is highly prevalent in DLB and correlates with cognitive, psychiatric, autonomic, and sleep-related features. These associations support that nutritional impairment reflects the multisystem disease burden. Early identification of patients with combined deficits may help target those at risk and guide comprehensive management.
PMID:42324708 | DOI:10.1002/ncp.70143
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