Alzheimer's disease (AD) is often accompanied and worsened by malnutrition.

The aim of this study is to investigate the relationship between weight loss and behavioral symptoms in institutionalized severe AD patients.

All subjects were recruited from Asahi Hospital, a long-term care facility.

The diagnosis of AD was made in accordance with the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria. The inclusion criteria were (1) an MMSE score of 12 or less, (2) stable physical condition for at least three months. Exclusion criteria were (1) presence of acute disorders such as infection, heart failure, or requiring special treatment and intensive care. Weight was measured monthly. At baseline, 12 weeks, and 24 weeks, each patient received the Mini-Mental State Examination (MMSE), the Barthel Index, and Neuropsychiatric Inventory (NPI).

We included 48 patients who were judged appropriate for the study. At baseline, the mean age was 83.3 ± 6.2, the mean weight was 41.8 ± 7.9, the mean body mass index (BMI) was 18.7 ± 3.5. During the 24 weeks of follow-up, 16 patients lost at least 3 kg of body weight, 20 patients remained stable, and 12 patients gained at least 3 kg of body weight. The mean NPI scores was significantly higher in the weight-loss group than in the weight-gain and weight-stable groups.

These preliminary results suggest that behavioral disturbances play a role in low body weight and weight loss in AD patients.