Linking behavioral and psychological symptoms to nutritional status in Alzheimer's disease: Clinical correlations and implications

OBJECTIVE: Behavioral and Psychological Symptoms of Dementia (BPSD) are highly prevalent in Alzheimer's disease (AD) and constitute a major therapeutic challenge. Although nutritional deficiencies are common among AD patients, their relationship with BPSD remains poorly understood. This cross-sectional study aimed to examine the association between multidimensional nutritional characteristics and BPSD in patients with AD. METHODS: A total of 102 patients with Alzheimer's disease were enrolled in this study and stratified into two groups based on the presence or absence of BPSD, as determined by comprehensive psychiatric assessment. We integrated Mini Nutritional Assessment (MNA) with a panel of serological biomarkers reflecting protein-energy status, glucose metabolism, and systemic homeostasis. Multivariate regression analyses were employed to identify nutritional factors associated with BPSD. RESULTS: AD patients with BPSD exhibited a distinct nutritional and metabolic profile, characterized by poorer MNA scores and lower prealbumin (PAB), as well as lower MMSE and ADL scores, and longer disease duration. Critically, after rigorous adjustment for confounders, higher MNA scores and higher PAB were independently associated with lower odds of BPSD. CONCLUSION: Our findings revealed that poorer nutritional status, particularly lower MNA scores and lower prealbumin levels, was associated with higher likelihood of BPSD. Integrating multidimensional nutritional assessment into clinical practice may help identify at-risk patients and inform therapeutic strategies. However, due to the cross-sectional design and sample imbalance, these findings are hypothesis-generating and require prospective validation.