JPEN. Journal of parenteral and enteral nutrition · 2025
Association between medium-chain triglyceride intake and Functional Independence Measure-cognition score in adults following stroke: A retrospective cohort study.
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Shimazu Sayuri, Yoshimura Yoshihiro, Wakabayashi Hidetaka, Momosaki Ryo, Nagano Fumihiko, Matsumoto Ayaka, Shiraishi Ai, Kido Yoshifumi, Bise Takahiro, Kuzuhara Aomi, Hamada Takenori, Yoneda Kouki
Аннотация
BACKGROUND: Limited evidence exists regarding the cognitive and physical improvement effects of medium-chain triglyceride (MCT) intake in patients with stroke. This study aimed to investigate the association between MCT-enhanced rice consumption and enhancements in outcomes, including cognitive level, in patients following stroke.
METHODS: We performed a retrospective cohort study on adults admitted to a rehabilitation center with cognitive decline following acute stroke. Our exposure of interest was 1 cup of MCT-enhanced rice 3 times per day. Our comparator was 1 cup of regular rice 3 times per day. Our primary outcome was the cognitive level, defined as the Functional Independence Measure-cognition (FIM-cognition) score (continuous variable) at discharge. Our secondary outcomes were changes in FIM-cognition from admission to discharge, defined as FIM-cognition gain, activities of daily living (determined by the FIM-motor score), and swallowing function (determined by the Food Intake Level Scale [FILS] at discharge). Propensity score matching and multivariable regression analyses were used to evaluate the association between MCT provision and the outcomes.
RESULTS: After applying the exclusion criteria, 659 patients with baseline cognitive impairment (mean age 76.1 years; 52.8% men) were analyzed. Following propensity score matching, patients who received MCT-enhanced rice showed significantly greater FIM-cognition gain (median [95% CI]: 9 [5,15] vs 8 [5,12]; P = 0.002) compared with those who did not. Additionally, the MCT-enhanced rice group exhibited significantly higher FIM-motor scores (59 [41,79] vs 56 [31,77]; P = 0.019) and FILS scores (10 [9,10] vs 9 [8,10]; P = 0.027) at discharge than those without. Multivariable linear regression analysis using the analytical cohort confirmed the independent association between MCT intake and improved discharge scores of FIM-cognition, FIM-motor, and FILS.
CONCLUSIONS: The provision of MCT-enhanced rice was associated with improved cognitive level, activities of daily living, and swallowing function in poststroke patients with cognitive impairment.
METHODS: We performed a retrospective cohort study on adults admitted to a rehabilitation center with cognitive decline following acute stroke. Our exposure of interest was 1 cup of MCT-enhanced rice 3 times per day. Our comparator was 1 cup of regular rice 3 times per day. Our primary outcome was the cognitive level, defined as the Functional Independence Measure-cognition (FIM-cognition) score (continuous variable) at discharge. Our secondary outcomes were changes in FIM-cognition from admission to discharge, defined as FIM-cognition gain, activities of daily living (determined by the FIM-motor score), and swallowing function (determined by the Food Intake Level Scale [FILS] at discharge). Propensity score matching and multivariable regression analyses were used to evaluate the association between MCT provision and the outcomes.
RESULTS: After applying the exclusion criteria, 659 patients with baseline cognitive impairment (mean age 76.1 years; 52.8% men) were analyzed. Following propensity score matching, patients who received MCT-enhanced rice showed significantly greater FIM-cognition gain (median [95% CI]: 9 [5,15] vs 8 [5,12]; P = 0.002) compared with those who did not. Additionally, the MCT-enhanced rice group exhibited significantly higher FIM-motor scores (59 [41,79] vs 56 [31,77]; P = 0.019) and FILS scores (10 [9,10] vs 9 [8,10]; P = 0.027) at discharge than those without. Multivariable linear regression analysis using the analytical cohort confirmed the independent association between MCT intake and improved discharge scores of FIM-cognition, FIM-motor, and FILS.
CONCLUSIONS: The provision of MCT-enhanced rice was associated with improved cognitive level, activities of daily living, and swallowing function in poststroke patients with cognitive impairment.