Eating and Nutrition in Dementia

The importance of food and meals

In recent years, there has been greater awareness that a healthy diet is an essential component in maintaining health and preventing disease, and even contributes to quality of life. Proper nutrition affects health at any age, and even more so during illness or old age.
Eating is significant in many ways: we eat to consume energy and essential substances for the body, but eating also has social, cultural and emotional significance. Food connects us to tradition and customs and brings back memories. We love to eat with friends and family and communicate during meals; food is a source of pleasure.

Eating problems in dementia

In dementia Eating functions may be impaired due to typical cognitive, linguistic, and behavioral phenomena.
For the disease. Some people overeat, while others, on the contrary, eat less, which can lead to malnutrition.

Food and the act of eating are important in maintaining quality of life as a source of pleasure and satisfaction in addition to their important role in maintaining health. Eating has an important meaning throughout life, even when it seems to us that the person is not functioning at all; eating is one of the last functions that is preserved.
People with dementia experience difficulties with nutrition and eating, which pose a significant challenge for caregivers. These difficulties appear in the early stages of the disease, but worsen as it progresses. Often, dealing with eating difficulties is very frustrating for primary caregivers and requires organization of meals throughout the day.
Impaired memory may cause the person to forget to eat or to forget that they ate. Sometimes the person does not initiate eating or has difficulty concentrating on the process. Poor motor planning leads to difficulty performing familiar activities such as using cutlery or opening the mouth. Impaired visual and spatial perception causes difficulty in positioning utensils or difficulty identifying items on a plate. A person with dementia may not always be able to talk about discomfort or pain in the oral cavity that makes it difficult to eat or express food preferences.
Swallowing and chewing problems leading to food retention in the mouth, drooling, coughing, choking, and food regurgitation.
Various difficulties usually appear gradually as the disease progresses.

Why maintain independent eating? Even when other functions are decreasing, eating remains and becomes one of the main activities in which the person participates. Therefore, despite the difficulties, it is important to allow the person to eat independently as much as possible, with the emphasis on the abilities that remain and are expressed during eating – cognitive, motor, communicative. The possibility of choosing at mealtime and the pleasure that the person derives from eating independently affect the quality of life. When the person eats and chooses on their own, it gives them a sense of control, competence and self-respect.

More on:

Eating Safely, With Dignity, and With Joy – A Guide to Eating for Caregivers of People with Dementia

To eat and live with dignity –  A guide for family members and caregivers of people with dementia

• What are the signs that may indicate problems with eating and food choices?
• Tips and recommendations for dealing with eating disorders in people with dementia
• Eating with fingers – “finger food”
• Example of a daily menu
• How do you deal with constipation?
• Changes in eating and swallowing as a manifestation of worsening dementia
• Dementia: During and After – In the Advanced Stages Useful Tips and Advice Before a Meal
• Soft, nutritious foods for people with eating, chewing, and swallowing problems
• Principles of sensible nutrition

For information on intermittent fasting and dementia, click here.

A diet rich in vitamins can delay Alzheimer's disease

For years, scientists have been searching for the causes of Alzheimer's disease. In light of the impressive progress made in genetic research, it is becoming clear that there are additional factors that can accelerate or prevent the onset of the disease. Two published studies have shown that a diet rich in vitamins, especially vitamin C and vitamin E, has a protective effect.
The studies were conducted in different countries, the USA and the Netherlands. The researchers followed a large group of elderly people. While they were still healthy, the subjects were asked about their food intake, and from this the researchers calculated the amount of vitamins in the food. Several years later, the elderly were tested again. As expected, some of them developed Alzheimer's disease, but this number was lower the more vitamins they consumed. On the other hand, taking vitamin tablets, which is common among the elderly, did not have such an effect.

The results of the studies were not surprising. Both vitamins have an antioxidant effect. In recent years, the importance of oxidative stress in the processes of degeneration of brain cells has become increasingly clear. An excess of oxidizing substances produced in the body causes damage to the membranes of nerve cells and accelerates their death. Vitamins are used as natural substances in many processes, including in the prevention of oxidative damage. The amount of vitamins needed by a person is not known exactly, and it is possible that the accepted recommendations are too low. In any case, the results of both studies emphasize the need for a balanced diet.
Vitamin C and Vitamin E are found in large quantities in various fruits, especially citrus fruits. Especially in leaves (such as cabbage, lettuce) and seeds (such as sunflower). In fats of plant origin, such as sunflower oil and soybean oil. Other vitamins that are important in preventing Alzheimer's disease are vitamin B12 and folic acid.

Alzheimer's disease is a very common disease in the elderly and poses a great burden on the family and society, including financially. The financial cost of this disease in the US is the third largest (after cancer and heart disease).
The existing treatments for this disease alleviate the manifestations of the disease but do not prevent its progression. It is not known whether the above vitamins slow the progression of the disease, however, preventing the onset of the disease is obviously preferable to slowing its deterioration.