Send to

Choose Destination
J Am Med Dir Assoc. 2004 Mar-Apr;5(2):89-97.

A 6-month observational study of the relationship between weight loss and behavioral symptoms in institutionalized Alzheimer's disease subjects.

Author information

Center for the Study of Aging and Human Development, Department of Medicine, Duke University Medical Center, Durham, NC, USA.



Weight loss is a common occurrence in Alzheimer's disease (AD). This study was undertaken to investigate the relationship between weight loss and behavioral symptoms in institutionalized AD subjects.


Observational study.


Two facilities that included assisted living and nursing care.


Residents with probable or possible AD (n = 32).


Weight was measured monthly. At baseline, month 3, and month 6, a knowledgeable staff member provided information that included the Neuropsychiatric Inventory: Nursing Home Version (NPI-NH, ie, a measure of behavioral symptoms) and a questionnaire regarding eating habits, food intake, and appetite. Two-day calorie counts were done and accelerometers were worn to monitor physical activity.


At baseline, the mean body mass index (BMI) was 24.0 (standard deviation, 3.5) with 12 subjects exhibiting a BMI <22. BMI was negatively associated with the baseline NPI-NH total score (Spearman Correlation Coefficient -0.52, P <0.01), which indicates that subjects with low BMIs were more likely to have higher frequency and severity of behavioral problems. Individual behavior scores for agitation/aggression (-0.40, P <0.05), depression (-0.31, P = 0.08), irritability/lability (-0.47, P <0.01), aberrant motor behavior (ie, pacing, -0.42, P <0.05), nighttime behavior (-0.37, P = 0.05), and appetite/eating (-0.48, P <0.01) at baseline were negatively correlated with baseline BMI. Behaviors not correlated with BMI were delusions, hallucinations, elation, apathy, and disinhibition. Although this was a small sample followed for a relatively short time period, change in specific NPI-NH scores from baseline to month 6 were correlated with the change in weight over the 6-month period. Both agitation/aggression (-0.37, P = 0.05) and disinhibition (-0.45, P <0.05) showed negative correlation with weight change, which indicates an association between changes in these behaviors and weight loss. There were no significant differences between those who lost weight (n = 13) and those who did not (n = 19) on baseline variables, which included age, comorbidity, functional status, and NPI-NH. However, those who lost weight had a significantly higher BMI at baseline than those who gained weight.


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

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center