ワカバヤシ　ヒデタカ   WAKABAYASHI Hidetaka   若林　秀隆    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Association between medium-chain triglyceride intake and Functional Independence Measure-cognition score in adults following stroke: A retrospective cohort study.
掲載誌名	正式名：JPEN. Journal of parenteral and enteral nutrition 略　 称：JPEN J Parenter Enteral Nutr ISSNコード：19412444/01486071
掲載区分	国外
巻・号・頁	49(8),pp.993-1001
著者・共著者	Sayuri Shimazu, Yoshihiro Yoshimura, Hidetaka Wakabayashi, Ryo Momosaki, Fumihiko Nagano, Ayaka Matsumoto, Ai Shiraishi, Yoshifumi Kido, Takahiro Bise, Aomi Kuzuhara, Takenori Hamada, Kouki Yoneda
発行年月	2025/11
概要	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.
DOI	10.1002/jpen.70011
PMID	40931391