Assessment of fecal Elastase-1 and nutritional status in dementia

Malnutrition is common in patients with dementia and contributes to adverse clinical outcomes. Pancreatic exocrine dysfunction may theoretically contribute to nutritional impairment through defective digestion and absorption. This study investigated the association between fecal elastase-1 (FE-1), a marker of pancreatic exocrine function, and nutritional status in older adults with dementia.

In this case-control study, 55 patients with dementia and 55 cognitively healthy controls were evaluated. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), cognitive performance using the Mini-Mental State Examination (MMSE), and pancreatic exocrine function using fecal elastase-1 (FE-1) measured by enzyme-linked immunosorbent assay (ELISA).

Dementia was associated with significantly poorer nutritional status and lower MMSE scores compared with cognitively healthy controls (both p < 0.001). However, FE-1 levels and FE-1 category distributions did not differ significantly between groups (p = 0.361 and p = 0.151, respectively). Correlation analyses demonstrated generally weak and non-significant associations between FE-1 levels, MMSE scores, and MNA parameters. In multivariable logistic regression analysis, dementia diagnosis was associated with an approximately threefold higher odds of malnutrition (OR = 3.249, 95% CI: 1.358-7.773, p = 0.008), whereas FE-1 levels were not associated with malnutrition status (p = 0.888).

Dementia was associated with an increased risk of malnutrition; however, FE-1 levels were not associated with nutritional status, cognitive performance, or malnutrition risk. These findings do not support a clear relationship between FE-1 levels and malnutrition in dementia, although a contribution of pancreatic exocrine function in specific clinical contexts cannot be excluded. Given the exploratory nature of the study, larger prospective studies are needed to confirm these findings.