林娉婷潘季群Ji-Cyun Pan營養學系2026-03-242026-07-1420212021-07-05https://handle.ncl.edu.tw/11296/5wk2x5https://scholars.csmu.edu.tw/handle/123456789/7151隨著全球老年失智症病人數量逐年攀升，與失智症相關之營養照護及肌少症之議題值得探究。本研究目的為了解失智症病人之輔酶Q10濃度及營養狀態與肌肉質量及肌力表現、衰弱、憂鬱及生活品質之相關性。本橫斷面研究招募60歲以上，簡易智能量表分數≤ 26分，並由醫師評估診斷為失智症之病人。收集研究對象之基本資料，以迷你營養評估量表及老人營養風險指標評估其營養狀態。利用雙能量X光吸收儀測定肌肉質量，測量握力、背筋力、手臂啞鈴彎舉、坐姿起立、六分鐘步行速率及簡短身體功能量表以評估其肌力表現，並以問卷了解其生活品質、衰弱及憂鬱狀態。採集血液樣本分析失智症研究對象之血漿輔酶Q10濃度及血液生化值。結果發現，約有八成失智症研究對象有輔酶Q10濃度缺乏，其輔酶Q10濃度之中位數為0.34 µM；約有四成者有營養不良風險（迷你營養評估量表< 24分），約有三成四之失智症研究對象罹患肌少症。經疾病嚴重度分組後，中度失智者之上臂環圍、小腿圍、全身及四肢肌肉質量指數皆顯著低於輕度失智者（p < 0.05），且具營養不良風險及營養不良之人數比例亦顯著高於輕度失智者（p = 0.02）。失智症研究對象之迷你營養評估量表分數及老年營養風險指標分數皆與肌肉質量及肌力表現呈顯著正相關（p < 0.05）。另失智症研究對象之血漿輔酶Q10濃度與簡易智能量表分數（r = 0.26，p < 0.05）及生活品質量表分數（r = 0.32，p = 0.01）呈顯著正相關；與衰弱量表分數呈輕微負相關（r = -0.25，p = 0.05）。利用邏輯式迴歸分析並調整年齡、性別及運動習慣後發現，失智症研究對象有較低血漿輔酶Q10/總膽固醇濃度（< 0.1 μmol/mmol）（危險對比值：9.15，p < 0.01）或營養不良風險（迷你營養評估量表< 24分）（危險對比值：3.61，p = 0.06）或較低之老年營養風險指標分數（≤ 107分）（危險對比值：8.75，p < 0.01）會顯著增加肌少症組成因子之風險。由以上結果推論，失智症病人多處於血漿輔酶Q10缺乏之情形，且輔酶Q10濃度與疾病嚴重程度、營養狀態、生活品質、衰弱及憂鬱狀態有關。當失智症病人有較高之輔酶Q10濃度或較佳之營養狀態時，會有較好之肌力適能表現。因此，我們建議失智症病人應監測輔酶Q10濃度及營養狀態，將有助於預防罹患肌少症，並提升生活品質。As the number of elderly with dementia is increasing worldwide, it is worthy to explore the relationship between nutritional status and the risk of sarcopenia in dementia. The purpose of this study was to investigate the associations between coenzyme Q10, nutritional status and muscle mass, muscle performance, frailty, depression, and quality of life in patients with dementia. We recruited patients who were over 60 years with the mini-mental state examination (MMSE) score ≤ 26 points, and had been diagnosed with dementia by neurologist and psychiatrist in this cross-sectional study. We collected characteristic data and assessed their nutritional status by mini nutritional assessment (MNA) and geriatric nutrition risk index (GNRI). Muscle mass was measured by dual-energy X-ray absorptiometry. Muscle performance was evaluated by grip strength dynamometer, dumbbell curl, back dynamometer, chair stand test, six-minute walk test and short physical performance battery. The quality of life, frailty, and depression status were assessed by questionnaires. Blood sample was collected to analyze the level of coenzyme Q10 and hematological data. The results showed that almost 80% of participants had coenzyme Q10 deficiency and the median concentration of coenzyme Q10 was 0.34 μM. Forty percent of participants were at risk of malnutrition (MNA < 24 points) and 34% of participants were suffered from sarcopenia. After stratified by the severity of dementia, participants with moderate dementia had significantly lower mid-arm and calf circumference, whole skeletal muscle mass index, appendicular skeletal muscle mass index, and high proportion at risk of malnutrition than those with mild dementia (p < 0.05). The values of MNA and GNRI were significantly positively correlated with muscle mass and muscle performance (p < 0.05). The level of plasma coenzyme Q10 was significantly positive correlated with MMSE score (r = 0.26, p < 0.05) and the quality of life (r = 0.32, p = 0.01); and slightly negative correlated with the frailty (r = -0.25, p = 0.05). In addition, participants with a low level of coenzyme Q10/total cholesterol (< 0.1 µmol/mmol) (OR: 9.15, p < 0.01) or risk of malnutrition (MNA < 24 points, or GNRI ≤ 107 points) (OR: 3.61, p = 0.06; OR: 8.75, p < 0.01) may increase the risk for the components of sarcopenia (p < 0.05) after adjusted for gender, age and exercise habit. In conclusion, patients with dementia may suffer from coenzyme Q10 deficiency and the level of coenzyme Q10 was related to the dementia severity, nutritional status, quality of life, frailty, and depression. As patients with dementia who had a better level of coenzyme Q10 or nutritional status may show a better muscle performance. Thus, we suggested that patients with dementia should monitor their coenzyme Q10 and nutritional status to prevent the risk of sarcopenia and improve their quality of life.輔酶Q10營養評估失智症肌少症生活品質coenzyme Q10nutritional assessmentdementiasarcopeniaquality of lifethesis