Dementia and Eating Issues

“Dementia and Eating Issues” was written by, Morgan Kuiper, Registered Dietitian and former dietetic intern at Oregon Health Sciences University. Reviewed/edited by, Katie Dodd, MS, RDN, CSG, LD, FAND.

*This article includes affiliate links. As an Amazon Associate I earn from qualifying purchases.

Introduction

What comes to mind when you think about dementia? Maybe you think of a loved one or someone in a facility who suffers from Alzheimer’s disease. Maybe you think of a movie scene with someone exhibiting dementia symptoms or a character in a book you’ve recently read.

Nutrition and eating is not what typically comes to mind when people think about dementia. However, nutrition is central to caring for those with dementia. Dementia and eating issues often go hand in hand.

When considering nutrition factors in those with dementia, it is important to focus health, independence, and quality of life. This can profoundly enhance the lives of those living with dementia.

What is Dementia?

Before we can dive in, we need to define what dementia actually is. This is tricky because dementia is a broad term that includes several different diseases and conditions.

“Dementia” is an umbrella term for diseases and conditions characterized by a decline in memory, language, problem-solving, and other thinking skills that affect a person’s ability to perform everyday activities (1).

Types of Dementia

Now that you know what dementia is, you may be wondering what the different types are. There are 11 different types of dementia, but to keep things simple, we’ll review the three most common types and list the other eight.

Alzheimer’s Disease 

Alzheimer’s Disease is the most common type of dementia, accounting for 60-80% of dementia cases (2). Our brain cells do a lot of jobs which require plenty of oxygen and fuel to keep things operating smoothly. We don’t know the exact cause of Alzheimer’s disease is, we do know that the disease stems from brain cells not functioning well (2). Issues in one area create problems in other areas of the brain. This sequence of events leads to cell death and permanent changes to the brain (2). These changes are what eventually manifest as Alzheimer’s dementia and its associated symptoms.

Vascular Dementia

Vascular Dementia is the second most common type of dementia, accounting for 5-10% of dementia cases (2). In vascular dementia, the cause of cell death in the brain is inadequate blood flow (2). Cell death leads to changes in the brain in areas critical for storing and retrieving information (1). Memory loss in vascular dementia is similar to that of Alzheimer’s disease (2).

 Lewy Body Dementia

Lewy Body Dementia is the third most common type of dementia, accounting for 5-10% of dementia cases (2).  Within the brain of those with Lewy Body dementia, deposits of “alpha-synuclein proteins” (termed “Lewy bodies”) alter brain chemicals. These alterations cause issues with thinking, behavior, movement, and mood (3).

Here is a list of some other, less common, types of dementia:

• Creutzfeldt-Jakob Disease
• Down Syndrome and Alzheimer’s Disease
• Frontotemporal Dementia
• Huntington’s Diseases
• Mixed Dementia
• Normal Pressure Hydrocephalus
• Posterior Cortical Atrophy
• Parkinson’s Disease Dementia
• Korsakoff Syndrome

Statistics on Dementia

So, how many people does dementia effect? Worldwide, 50 million individuals have dementia. Each year, there are 10 million new cases. In the older adult population, dementia is a major cause of dependence and disability (4).

In the United States, roughly 50% of caregivers who care for older adults provide care for an individual with dementia (5).

Stages of Dementia

Every individual with dementia is different. How they experience it. How far along they are in their disease.  There is a lot of uncertainty when it comes to the progression of dementia.

Let’s look at what we do know. There are different stages in dementia. To describe these stages, we will look at the three stages of Alzheimer’s disease (since this is the most common type of dementia). It is projected that an older adult will live an average of 4 – 8 years after being diagnoses with Alzheimer’s disease. But we know some older adults can easily live another 20 years! Progression can be slow and uncertain (5).

There are three stages of Alzheimer’s disease: the early stage, middle stage, and the late stage. The early stage is the least severe, while the late stage is the most severe. Let’s take a closer look.

Early Stage (Mild):

Usually, in this stage, a person can function independently. However, will notice memory lapses. For instance, they may forget where they put their keys or forget common words.

The following tasks may also become difficult: remembering the names of recently-met individuals, tasks in work or social settings, and planning and organizing.

Middle Stage (Moderate):

Symptoms of dementia are more severe in this stage. Those with Alzheimer’s disease will usually require more care during this stage.

Certain tasks may become harder and memory will continue to decline. However, major details about one’s life may still be remembered.

Frustration, anger, and unexpected behavior are common in this stage. Changes in behavior may become more pronounced. These may include surrounding individuals, forgetfulness, moodiness, and personality and behavioral changes.

Late Stage (Severe):

Severe symptoms are present in this stage. This includes difficulty holding out a conversation, responding to their environment, and lack control over their movement. Personality changes, problems communicating pain, and the need for ongoing assistance with everyday activities should be expected.

An individual with late stage Alzheimer’s disease may have trouble remembering recent experiences and may be more susceptible to infections, especially pneumonia.

How Dementia Impacts Health

You now know what dementia is, the different types of dementia, a few statistics, and the different stages. You are probably reading this post because you want to learn about how dementia impacts the health of loved ones, patients and clients, or yourself – or maybe all of the above!

A good starting point is the symptoms, signs, and complications of dementia.

Symptoms of Dementia

Each person with dementia is unique.  Symptoms may be different and vary by the individual person. Keep in mind that these symptoms might be mistaken as a “normal” part of the aging process. However, dementia is not considered a normal part of aging. Concerns about symptoms should be discussed with a medical provider and health care team (6).

Common symptoms of dementia may include the following (7):

• Difficulty remembering recent events
• Confusion
• Poor concentration
• Changes in behavior and/or personality
• Feelings of apathy
• Withdrawal or depression
• Difficulty with performing everyday tasks

Signs of dementia

Signs are objective evidence of disease. They are things that the person experiencing them might not pick up on. It’s typically other individuals who observe these signs.

Here are some important signs of dementia (6, 7):

• Frequently forgetting things and remembering them later, or not at all
• Difficulty with remembering all of the steps of a task, such as cooking dinner
• Repeating the same questions over and over
• Trouble finding a common or familiar location
• Taking longer to complete typical tasks during the day
• Forgetting basic words when speaking/writing
• Substituting an unsuitable word into a sentence
• Difficulty with abstract thinking, especially in tasks related to managing finances
• Using poor judgement – for example wearing a winter coat on a hot summer day
• Poor ability to evaluate distance or direction
• Misplacing items (like one’s keys or wallet)
• Not knowing what familiar items are used for
• Not being able to complete tasks on their own
• Having a hard time remembering the names immediate family members
• Rapid mood swings
• Lack of interest in activities that were previously enjoyed or valued

Complications of Dementia

Certain health conditions often occur as a result of having dementia. It is important to be aware of these conditions so steps can be taken to prevent them if possible.

Here are six major complications of dementia:

• Malnutrition and dehydration
• Depression
• Fall-related injuries
• Urinary tract infections
• Immobility (may lead to pressure wounds, reduced muscle function, and/or infection)
• Pneumonia

Dementia also increases risk of death. Alzheimer’s is the 6^th leading cause of death among older adults.

It is estimated that 1 in 3 older adults die with Alzheimer’s or another dementia (5).

Dementia and Eating Issues

Food and nutrition play a very important role in health and quality of life throughout the entire lifespan. Older adults are no exception to this and require optimal nutrition! Dementia and eating issues can be quite common. Individuals with dementia have some unique nutrition concerns and challenges. 

Dehydration

Eating and drinking go hand in hand. In addition to eating issues, dementia can also cause a person to drink less fluids and in turn become dehydrated.

Water does so many important things in the human body. Fluids aid in including lubricating our joints, driving nutrient-rich blood to our muscles, and controlling our body temperature (8).

We need to keep in mind that dehydration has some early, mild symptoms including muscle cramps, dry mouth, and dizziness. These are symptoms that could easily be attributed to medications or other health conditions(8).

Overlooking fluid intake and the early signs of dehydration can lead to more significant consequences. These include rapid heart rate, challenges with walking, and/or confusion, which might lead to a hospital visit (8).

Poor Appetite

Decreased appetite is common among older adults – so common that we have a name for it: anorexia of aging (9). Many different things can cause poor appetite in older adults.

Take a minute to think about the cues you get when you are hungry. Those hunger cues tell us when it’s time to eat. But, if these cues start to decline and we don’t have much of an appetite, food intake inevitably decreases. So, if you think about it, those annoying lunchtime stomach growls that we get are actually really important!

Additionally, meal time challenges that many older adults with dementia experience (ex. forgetfulness, trouble using utensils, and inattention) further reduce food intake.

Forgetting to Eat

Okay, this one might seem obvious, but there’s a little bit more to it than we realize. Yes, an individual with dementia may simply forget to eat. However, they could forget more specific details related to eating, such as when, how much, or what they ate.

Confusion about these things could lead an individual with dementia to eat several meals or overeat at one meal. They may also eat the same thing several times per day if they’ve forgotten that they ate that food earlier.

It is also possible that a patient with dementia might forget which foods they like to eat and express a general lack of interest in what is offered to them.

Weight Loss and Malnutrition

Dementia-related weight loss can be caused by many different things. Unintended weight loss and poor food intake can lead to malnutrition, which has serious health consequences. Malnutrition can also reduce mobility, impair posture, decrease strength, and increase fall risk (10).

Additionally, malnutrition can weaken the immune system, prevent wounds from healing, and cause problems in the eyes, brain, and kidneys (10). Malnutrition also negatively affects the heart and lungs, GI health, and mental health (11).

NOTE: The High Calorie SHAKES e-Cookbook available with 25 delicious recipes to STOP unintended weight loss in older adults.

Strategies for Improving Dementia and Eating Issues

Improving dementia and eating issues comes with several challenges and hurdles to overcome. What works for each person will vary. And, it may require some trial and error to figure out what works. This next section will provide some simple tips that can help patients eat more at mealtimes and boost their nutrition status.

The Dining Environment

The environment where we eat can influence how much food we eat. Especially in those with dementia and eating issues.

Two big strategies to support patients with dementia with regard to the dining environment include:

1. Limiting distractions
2. Fostering a positive dining environment.

For many, eating meals in front of the TV while catching up on Netflix or on the computer responding to emails is the norm. However, distractions in the dining environment can significantly reduce food intake in patients with dementia.

Serve and eat meals in a quiet, undisturbed environment. Distractions can range from background noise or talking to a cluttered dining room table. Limit distractions as much as possible and make food the focus!

Eating meals with others may help patients with dementia eat better (12). Aim to create mealtimes that are social and joyful. This can help make food and eating feel enjoyable. This way they start to look forward to eating.

Adequate lighting is important because older adults often require brighter lighting than younger individuals do.

In the dining room, it is helpful to add more lights and uncover windows (if possible) to allow natural light to enter the room.

Appropriate lighting aids older adults with dementia in seeing and recognizing the foods served to them, making it much easier to eat.

Foods to Encourage

You may be feeling super overwhelmed and confused about what the best foods to serve. The good news is that it’s not all that complicated! 

Here are some simple guidelines to follow and things to keep in mind. Remember that food and nutrition are very individual and that each patient’s preferences and needs will look different.

Familiar/Favorite Foods:

Provide foods that the patient likes to eat. These foods may be more easily recognized and comforting to the patient. Plus, if the patient likes them, they probably taste great! If a loved one has a favorite type of sandwich or a casserole dish that they eat often, offer and encourage these options.

Make Small Accommodations in Food Preparation:

If an individual with dementia really likes foods that are sweet, try adding some sweeteners to foods or opting for sweeter fruits and vegetables. On the flip side, more savory foods might be appropriate for a patient with dementia who prefers savory flavors.

Variety:

A healthy diet includes different types of fruits and vegetables, whole grains, lean protein, and dairy. Even though a patient with dementia may be struggling with food intake, do your best to provide a varied diet to help meet their nutritional needs through food.

Aim to serve different fruits and vegetables throughout the week (as many different colors as possible!) and expand the protein or whole grain sources, if tolerated.

Healthy Fats:

Foods high in fat have more calories in smaller volumes than carbohydrate or protein-rich foods.  What to do if a patient with dementia has difficulty finishing meals and isn’t getting enough calories? Try adding some additional fats to meals and snacks. This can help tremendously. This will increase the amount of calories the individual is getting from the amount food they are eating.

Try cooking with olive oil or adding it to meals, incorporating nuts or nut butters into snacks, adding avocado to toast or sandwiches, or topping meals with cheese.

New Foods:

Familiar foods are great, but don’t forget about new foods. Remember that some patients with dementia actually experience changes in their food preferences. Or they may simply forget that they previously enjoyed certain foods.

In this case, be open to what the patient wants. Try to provide the desired foods. However, remain aware that unfamiliar foods could cause problems with digestion or create some gastrointestinal discomfort. Always do what is in the patient’s best interest while honoring their independence and desires.

Meal Schedule

The generally-accepted three meals per day with some snacks mixed in might not be quite right for a patient with dementia. And that’s okay! Maybe small meals throughout the day will work better. Or even two larger meals per day. Let them choose their meal schedule and then be receptive to it.

If possible, try to keep the schedule as consistent as possible. Encouraging meals and snacks at the same times each day can help establish a common routine. In turn, this might improve their intake. Familiarity with a meal schedule can also help caregivers monitor intake. They can identify the need for a nutritional supplement or diet modification(s).

Dementia and Eating Issues: Make Mealtimes Easier

For so many reasons, mealtimes can be downright difficult. This goes for the individual with dementia, health care staff, family members, and/or caregivers. Luckily, there has been some great research on factors that help to make mealtimes easier. And there are plenty of things that you can do to make a positive difference!

Colors (Red Plates for Dementia)

A patient with dementia might struggle to distinguish between a plate and a table setting, food and the plate it is served on, or liquid and its container.

One thing that helps with this is providing contrast in colors. Try serving foods on a plain plate (or bowl) with a colored place mat underneath.

This assists the patient with differentiating between the plate and the food, and can make it much easier to eat meals.

Researchers at Boston University found that when patients with dementia were served food on a red plate, their food intake increased by 25% (13).

You can buy disposable red plates* to test if this will help. Or you can purchase a nice set of ceramic red plates* or a set of red dinnerware*.

The use of yellow plates for feeding patients with dementia has also shown to be effective for increasing intake in trials by the NHS in hospitals (13).

On of our followers on Instagram saw a post we made about red plates.

They tried this simple swap and were so excited to see the person they cared for finish their meal. That hadn’t happened in a long time. But this simple swap make all the difference.

Here is the photo they shared with us!

Texture of Food is Important

The role of texture in the diet of patients with dementia is two-fold.

First, the texture of foods can either promote or discourage adequate food intake.

Second, specific texture modifications may be required for patients with dementia who have difficulty chewing or swallowing.

Expectation and Preference 

Of course, the taste and smell of foods play a key role in the experience and enjoyment of eating. But we often overlook the texture of foods and how foods feel in our mouth.

Imagine going to eat a dish that you expect to be crispy or crunchy, but is actually soggy. This would be quite disappointing and unappetizing.

If you add in decreased appetite and a limited attention span? You can imagine this would be a recipe for poor food intake.

Be sure that textures are suited to the dish or food served to patients with dementia. Also pay attention to preferences. Does your patient or loved one with dementia prefer for crunchy foods over soft foods? Or perhaps they like creamy textures complemented by crunchy toppings? Do your best to accommodate them whenever possible.

Texture Modification

Texture modification is essential for patients with dementia who also have trouble swallowing and/or chewing. The medical term used for difficulty swallowing is “dysphagia.” In general, soft foods are much easier to swallow and thicker liquids are easier to swallow than thin liquids, such as water.

Dysphagia diets range from pureed to soft to mashed, and fluids can be thickened to the appropriate consistency or purchased pre-thickened.  Following a dysphagia diet reduces one’s risk of aspiration (food accidentally entering the lungs), which can quickly create many serious medical problems for an older adult, such as pneumonia (14).

Follow all instructions from medical providers carefully when preparing food for an individual on a dysphagia diet. These modifications are critical for safety and permit adequate intake even when swallowing is challenging to perform. A geriatric dietitian can help you navigate dysphagia diets and assist with food preparation techniques!

You can also learn more about the 15 best foods to eat without chewing.

Finger Foods

Because many individuals with dementia have a difficult time using eating utensils, we need to discuss the best food alternatives that allow us to get around this challenge. Our goal is to maintain independence, so we must strive minimize the use of feeding assistance.

How do we do this? With the help of amazing finger foods!

Finger foods are a wonderful “plan B” for patients with dementia who aren’t able to use eating utensils. They allow an older adult to continue eating on their own. But, without the burden of using utensils. Using utensils is a skill that may become quite hard. Finger foods also take some pressure off of caregivers who feel like they must spoon feed an older adult with dementia who cannot use utensils.

Do your best to provide finger foods that meet the food likes and dislikes of a patient with dementia. Keep in mind that some finger foods might be easier to eat than others.

Additionally, provide foods that match the individual’s level of eating ability. For example, a sandwich is easier to hold and eat than something like chips and dip, which require more maneuvering and coordination.

Here are some finger foods to try out with your patients or loved ones:

• Sandwiches, hamburgers, and wraps
• Meatballs or sliced meatloaf
• Sliced fruit
• Granola bars
• Trail mix
• Toast with butter and/or jelly
• Muffins, bagels, and pastries
• Peeled hard-boiled eggs
• Cubes of cheese
• Cut-up roasted potatoes, sweet potatoes, or other small vegetables
• Crackers with peanut butter
• Carrots, celery, and sugar snap peas with hummus or ranch

Adaptive Eating Equipment

Now that we’ve briefly discussed independence in eating and finger foods, let’s chat about some of the extremely helpful adaptive eating equipment.

When it comes to dementia and eating issues, having a hard time using utensils is a major issue. Adaptive eating equipment can make a huge difference in eating ability for individuals with dementia.

There are tons of different types of adaptive eating equipment available. So, in this section we will cover some of the common equipment and items that align most with common eating difficulties in patients with dementia.

Please note that an occupational therapist is your go-to professional to help with adaptive eating and increased independence at home. Talk to your medical team for individual advice nd recommendations.

Utensils with Large, Rubber Handles

These are easier to hold than a standard fork, and some can be bent to unique angles. You can also buy foam tubing to put over standard silverware.

Scoop Plates and Bowls

These have a built in high edge. This wall makes it easier to load food onto utensils as you scoop against the wall of the plate or bowl.

Plate Guards

These are similar to scoop plates. However, they are attached to the edge of a plate. They also provide a surface for individuals to push food against, making it much easier to get food onto utensils while eating or scooping foods.

Cutout Cups

These plastic cups have a small U-shaped section cut out which allows clearance of the patient’s nose. The design is ideal for patients who have limited neck mobility or have difficulty swallowing and need to have their chin tucked during the swallowing process.

Weighted or Non-slip Bowls and Plates

These bowls and plates stay in place on the table when individuals eat. You can also use a slip proof mat to keep plates and bowls in place.

Cups with Lids and Straws

There are different cups available with spill proof lids and/or straws. These can help to prevent spills and make it easier to get the cup to their mouth.

Hand over hand feeding/other feeding techniques

If a patient with dementia requires physical feeding assistance from another person, the hand over hand feeding technique can help to maintain independence and meet their need for assistance.

This technique is performed by placing a hand underneath the patient’s hand and guiding the eating utensil from the bowl or plate to the patient’s mouth. The main objective is to do this with the individual instead of for them or to them.

Promoting Independence in Eating

While being available to support a patient with dementia in their daily life is tremendously helpful, maintaining the patient’s independence as much as possible is of high importance.  Independence promotes self-esteem, dignity, and confidence in patients. As a caregiver, you can promote independence in feeding to honor the patient’s autonomy and self-sufficiency.

Why Independence is Important

Many patients with dementia will lose their ability to perform day-to-day tasks, including eating, as the disease progresses. When patients are given the tools and resources that they need to continue performing tasks and activities on their own, this maintains a sense of normality.

A feeling of dignity develops from independence and has a positive influence on the patient’s life. Regardless of the medical condition an older adult has, each and every older adult deserves to be treated with dignity and respect. Dementia is no exception.

Dementia and Eating Issues: Role of the Caregiver

You may feel as though your responsibility as a caregiver is to do it all!

Provide the right foods. Create the best possible environment. Feed the patient you are caring for. And make sure that the patient eats adequately. No matter what.

This is a BIG undertaking, and is probably completely overwhelming! Let’s break this down and discuss what your role is.

Simply put, you have three roles as the caregiver:

1. Provide healthy, safe, and desirable foods and beverages to the patient you are caring for in adequate amounts.
2. Allow the patient to do as much self-feeding as they can. To support this, use adaptive feeding equipment, food modifications, and create a dementia-friendly eating environment for the patient.
3. Monitor food intake, note any food-related changes, and provide help with eating as necessary.

Caregiver division of responsibility

The Division of Responsibility in Feeding is typically used by parents as a model for feeding infants and children. However, we can apply the same core principles to caregivers involved in feeding patients with dementia. The classic Division of Responsibility in Feeding states that the parent is responsible for the “what, when, and where” of feeding, and the child determines “how much and whether” to eat the food provided by the parent.

If we modify this so that it is suitable for caregivers and dementia patients, the statement might look something like this:

“The caregiver determines what foods are provided and the patient determines how much, when, and whether to eat what the caregiver provides.”

That’s it! Dementia and eating issues can be hard. Give yourself grace. Focus on what you can control.

Emotions and Caregiver Guilt

A common caregiver response to poor food intake in patients with dementia is guilt. Caregivers feel as though they are responsible for how much and what their patient or loved one eats. This is a huge weight for the caregiver to carry.

In addition, when a patient struggles with eating this can cause them to eat less and lose weight. This can create a lot of different emotions for the caregiver. Feelings of sadness, hopelessness, frustration, and grief are common.

These are normal feelings in caregivers. However, keep in mind the limitations of your role in feeding. And that several dementia and eating issues are not within your control.

Tube Feeding in Older Adults with Advanced Dementia

What happens when food intake significantly decreases? And weight loss and malnutrition become a concern? Tube feeding may be considered at this point. Tube feeding can be an effective and even life-saving intervention. However, in older adults with advanced dementia, tube feedings may not be the best option.

There are some important considerations to be aware of when weighing the pros and cons of tube feeding in this population.

Research and Statistics 

Tube feeding comes with certain risks and drawbacks. Below are some important facts and statistics about tube feeding for patients with dementia to be aware of (14):

• No evidence indicates that tube feeding prevents aspiration, reduces pressure sore risk, improves function or cognitive ability, or prolongs survival.
• Tube feeding has many side effects, including aspiration, infection, increased oral secretion, tube malfunction, and discomfort.
• Increasing intake of calories through tube feeding does not necessarily translate to desired outcomes, such as decreased hospital morbidity and mortality or increased quality of life.
• It may be burdensome or even detrimental to force a patient with dementia to receive food and/or fluids. These practices will not enrich or extend life.

Position on Tube Feeding in Advanced Dementia

The American Geriatrics Society’s position on tube feeding in advanced dementia states:

“when feeding difficulties arise, feeding tubes are not recommended for older adults with dementia” and that “health care providers should promote choice, endorse shared and informed decision making, and honor preferences regarding tube feeding” (15).

Healthcare providers have the responsibility to inform patients about the science, then support and reinforce the patient’s wishes. They should be considerate of the fact that a patient’s choice may not be the choice that you would make personally, and that support for the patient is necessary regardless.

Quality of Life in Dementia Patients

Many of us have positive thoughts and memories about food and eating. The delicious taste of certain foods. Enjoying meals with others. Family traditions. Favorite recipes. Celebrations often surround food, as do good memories.

Food plays a pretty big role in our quality of life.

For a patient with dementia, food and mealtimes may provide comfort, social interaction and connection to others, and a sense of purpose. It is important that quality of life remains at the forefront of care for patients with dementia.

If tube feeding is not the best option, remember that you have other options to help with dementia and eating issues!

Hand feeding a patient with dementia can be successful. In fact, the American Geriatrics Society reports that hand feeding has proven to be equally as effective as tube feeding for the following outcomes: aspiration, pneumonia, functional status, death, and comfort. Hand feeding also reinforces the pleasure and socialization that come along with maintaining oral intake as the primary source of nutrition (15).

Preventing Dementia

Now let’s shift gears to talk about how to possibly  prevent dementia in ourselves and our loved ones. A variety of lifestyle factors can assist with preventing dementia – including diet!

Link Between Diet and Dementia

We have heard time and time again about the importance of a healthy diet. This may be for maintaining a healthy body weight, reducing our risk of heart disease, and preventing other chronic diseases, like diabetes and cancer. As more research is performed and published, we are learning about the connection between diet and brain health.

What we currently know is that diets low in total fat, saturated fat, and cholesterol, and high in whole grains, fruits, vegetables, low-fat dairy, nuts, poultry, and fish are beneficial in reducing dementia risk (16).

The MIND Diet

The MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) Diet combines principles of the Mediterranean and the DASH diet. According to epidemiological studies, compliance to the MIND Diet is associated with reduced risk of Alzheimer’s disease (17).

The MIND Diet encourages the following foods:

• Green, leafy vegetables
• All other vegetables
• Berries
• Olive oil
• Nuts
• Whole grains
• Fish
• Beans
• Poultry

The MIND Diet recommends avoiding or limiting the following foods:

• Butter and margarine
• Red meat
• Fried foods
• Sweets
• Cheese

This eating pattern can be helpful in maintaining good brain health.

Other Ways to Prevent or Delay Dementia Onset

Here are some additional ways to potentially prevent or delay the onset of dementia (18):

• Exercise regularly
• Get adequate sleep
• Participate in activities that are cognitively stimulating
• Connect socially with others

Keeping the mind and body active is an important way to prevent or delay the onset of dementia. This includes maintaining social contacts and having some fun!

Role of the Geriatric Dietitian

Having a strong team of health professionals involved in the care of a patient with dementia makes a very positive impact on their health and quality of life. One member of that team is a geriatric dietitian. A geriatric dietitian is uniquely qualified to assist in a range of different nutrition-related areas relevant to older adults. They are your go to when it comes to dementia and eating issues!

Here are just some things that a geriatric dietitian may be able to help with when it comes to nutrition for patients with dementia:

• Promoting and supporting adequate food intake
• Preventing unintended weight loss and malnutrition
• Making recommendations to optimize the eating environment
• Providing recipes and helping with meal planning
• Recommending supplements or specific foods to encourage based on individual needs and preferences
• Provide education surrounding decisions on tube feeding
• Educating patients, providers, and/or caregivers on topics such as adaptive feeding equipment, oral health, and feeding assistance
• Enhancing the patient’s quality of life through food and nutrition

Additional Reminders of Why Nutrition is Important

Let’s bring things full circle. And touch on some reasons why nutrition is so important. Not only for patients with dementia, but older adults in general.

First, older adults have various risk factors for malnutrition, including poor appetite, dysphagia, and dietary restrictions. It is important to encourage good food intake to prevent malnutrition. Malnutrition can be detrimental to an older adult’s health.

Second, sarcopenia (the decline of skeletal muscle tissue with age) is common in older adults. Sarcopenia is a key cause of functional decline and loss of independence. Therefore, ensuring adequate protein intake and maintaining skeletal muscle mass is essential (19).

Third, nutrition at the end of life should always be focused on the patient’s quality of life. Remember that the patient’s wishes and best interest should guide decisions around tube feeding and any dietary modifications.

Dementia and Eating Issues Conclusion

Well, we sure have covered a lot! We’ve discussed the different types of dementia, nutrition concerns in patients with dementia, decisions around tube feeding, and the prevention of dementia.

After reading this post, hopefully you walk away with an overall understanding of dementia. Of how you can help an individual affected by dementia with their nutrition. And what your role in the a patient’s nutrition care is.

Food and nutrition are powerful in improving and supporting our health. Additionally, it enhances our quality of life. And it sustains dignity and independence. We hope the information in this post was helpful. And added a few tools to your toolbox so that you can provide the best care possible when it comes to dementia and eating issues.

References

1. What is Dementia? Alzheimer’s Association website. https://www.alz.org/alzheimers-dementia/what-is-dementia. 
2. Types of Dementia. Alzheimer’s Association website. https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia. 
3. What is Lewy Body Dementia? National Institute on Aging website. https://www.nia.nih.gov/health/what-lewy-body-dementia.
4. World Health Organization website. https://www.who.int/news-room/fact-sheets/detail/dementia. 
5. Facts and Figure. Alzheimer’s Association website. https://www.alz.org/alzheimers-dementia/facts-figures. 
6. The Truth About Aging and Dementia. Center’s for Disease Control and Prevention website. https://www.cdc.gov/aging/publications/features/dementia-not-normal-aging.html. 
7. Dementia – early signs. Better Health Channel website. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dementia-early-signs. 
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