Association Between the Prognostic Nutritional Index and Cognitive Function Among Older Adults in the United States: A Population-Based Study

Article type: Research Article

Authors: Zhou, Jie^{a; 1} | Ma, Luping^{b; 1} | Zhao, Lulei^d | Sheng, Jiamin^b | Xu, Yuhua^a | Chen, Jie^e | Yu, Liangjun^a | Sun, Quan^a | Zhou, Hangyang^f | Zhu, Shaofeng^a | Lu, Zefeng^g | Wei, Bo^{c; *}

Affiliations: [a] Department of Radiology, Shaoxing 7th People’s Hospital, Shaoxing, Zhejiang Province, China | [b] Department of Radiology, Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang Province, China | [c] Department of Neurology, Shaoxing People’s Hospital, Shaoxing, Zhejiang Province, China | [d] Department of Radiology, Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang Province, China | [e] Department of Laboratory Medicine, Shaoxing 7th People’s Hospital, Shaoxing, Zhejiang Province, China | [f] Department of Radiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Shaoxing, Zhejiang Province, China | [g] Department of Radiology, Shaoxing Second Hospital, Shaoxing, Zhejiang Province, China

Correspondence: [*] Correspondence to: Bo Wei, Department of Neurology, Shaoxing People’s Hospital, Zhongxing North Road 568, Shaoxing, Zhejiang Province, 312000, China. Tel.: +86 188 8870 3083; E-mail: [email protected].

Note: [1] These authors contributed equally to this work.

Abstract: Background:Nutritional status has been recognized as an important factor influencing cognitive function-related diseases, but few comprehensive nutrition indicators are available to assess the risk of cognitive decline. Objective:This study aimed to investigate the relationship between the prognostic nutritional index (PNI) and cognitive function in an elderly population, and the differences in nutrient intake between different levels of nutritional risk. Methods:Based on cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014, we included 2,564 older participants. The lower quartile of each of the four cognitive tests was considered to have cognitive function impairment (CFI). Binary and multivariate logistic regression models were used to estimate the relationship between the PNI and the odds ratio of CFI. Results:After adjustment for confounding variables, we found that the odds of CFI were significantly lower for participants with normal PNI levels than for those with low PNI levels. In a comparison of global cognitive impairment scores, participants with a normal PNI had lower ratios of poor cognitive performance than those with a low PNI. By comparing the nutrient intake at different PNI levels, we found a reduction in the intake of protein, dietary fiber, total saturated fatty acids, and multiple micronutrients in the low PNI group. Conclusion:Our study shows that the PNI can be a good predictor of the odds of CFI in the elderly population and that it is a convenient indicator of reduced intake of nutrients which may be important to brain health.

Keywords: Cognitive function impairment, malnutrition, national health and nutrition examination survey (NHANES), older adults, prognostic nutritional index

DOI: 10.3233/JAD-210141

Journal: Journal of Alzheimer's Disease, vol. 83, no. 2, pp. 819-831, 2021