dementia and eating - ReaDementia

Why Do Dementia Patients Eat So Much?

Dr. Muhammad Usman Blog, Signs February 24, 2021October 16, 2021dementia, dementia and eating, food

A comprehensive answer to the frequently asked question, Why do dementia patients eat so much, is here, written by a doctor and nutritionist.

The differences in appetite between dementia patients vary. Some eat too little, yet others overeat. Some dementia patients may consume too much food in one sitting or eat too many meals in a day.

But why does that occur?

Patients with behavioral variant frontotemporal dementia generally tend to overeat more.

Also, such patients develop a liking for food with a strong smell or taste and tend to eat the same food repeatedly (1).

For instance, very spicy, salty or sugary foods.

It’s also common to observe excessive eating and other related eating behavioral changes in dementia patients as their dietary preferences change.

Some even develop a seemingly inexplicable obsession with certain foods.

Managing Overeating and Dementia

Diagnosed dementia patients will experience a decline in their memory, problem-solving, and other thinking-related skills.

Alzheimer’s disease is the most common type of dementia and patients’ appetites usually change as a result of this.

What Causes A Dementia Patient To Eat More? – Four Possible Factors

Globally the dementia statistics continue to rise. A predicted 75 million people are expected to be diagnosed with the disease by 2030.

One in three elderly people dies from Alzheimer’s or another form of dementia in the US alone.

Dementia affects each aspect of living and poses hurdles that are rather unusual and challenging. Research indicates three of the main reasons dementia patients eat so much include:

1: Diminishing Taste Buds

As people age, their taste buds diminish. As their disease worsens and their taste buds weaken, the insulin levels in their brains can decrease.

Some dementia patients, therefore, experience intense cravings for foods containing high calories. They may prefer heavy or flavor-filled foods such as sugary sweets.

2: Changing Appetite

Also, dementia patients’ appetites change which results in craving unhealthy foods. If a patient overeats, they may eat inappropriate foods. They may even try to consume things that aren’t food, such as a napkin or bar of soap.

This is because they might not recognize the item or understand its use, and therefore they confuse it for food.

3: Forgetting Recent Meals

Due to their declining memory, dementia patients may forget that they’ve recently eaten.

They may frequently ask or search for food. Also, they may be concerned about when their next meal will be. This leads them to eat more.

4: Changes in Mood Might Affect Food and Eating Preferences

It is not uncommon for people with dementia to suffer from co-existing mental health issues, such as depression and anxiety.

One way they find comfort is by eating more or indulging in foods that give them a sense of comfort, which are often sweet and over-indulging (2).

How to Help a Dementia Patient Eat Less?

It can become problematic if a dementia patient eats too much.

It’s important to ensure they’re consuming nutritious food to stay healthy and avoid becoming overweight.

Some patients may refuse help when eating, and they also might not be able to adequately express this.

It’s better not to pressurize a dementia patient to eat or drink when they’re anxious.

Some ways to cater to changing eating habits in dementia patients are as follows:

1. Accept unusual food combinations: Strange mixing of food isn’t likely to cause patient harm, especially if the food is healthy and in appropriate portions. It’s better to acknowledge rather than challenge this.

2. Satisfy sweet cravings for healthier alternatives: If a patient likes sweet foods, try incorporating fruit or naturally sweet vegetables such as carrots or sweet potato into their meals.

How to monitor what patients with dementia eat?

Solutions to monitoring what a dementia patient eats include:

Cutting food into bite-sized pieces: This assists the patient and makes eating easier, especially if they aren’t able to use utensils by themselves.
Eating in company: By enjoying a meal together with a loved one, a patient is more likely to eat the healthy meal you’ve served them.
Fortifying the prefrontal cortex: This controls a patient’s dietary self-restraint. Help by ensuring they avoid alcoholic beverages, sleep sufficiently, and exercise if they’re able to.
Including plenty of protein: As far as possible, incorporate eggs, milk-based pudding, or protein powder in the patient’s meal.
Puréeing their vegetables: Patients are more likely to consume softer vegetables.

If a dementia patient is overeating and you’d like to help them to eat less, try the following approaches:

Generously serve salad and vegetables: Carbohydrates and starch should take up less than half of a plate.
Halve the original portion: Start by halving the patient’s original portion. Only offer them the second half should the patient request more food.
Keep them occupied: A patient will feel less bored or lonely if they have something to do and keep busy.
Offer healthy snacks: Make bite-sized cut pieces of fruit or other healthy nibbles easily accessible.
Replace a second helping with a drink: Rather than offering the patient more food, give them a “treat” drink such as hot chocolate or a milkshake.

Guidance for Good Nutrition

To ensure a dementia patient is eating correctly, a balanced diet including various foods is key.

Meals should contain fruit, lean protein foods, low-fat dairy products, vegetables, and whole grains.

It is recommended to serve small portions of high saturated fat and cholesterol in a meal.

While some fats are healthy, it’s best to use butter, fatty meat cutes, lard, and solid shortening sparingly.

Also, high-sodium foods should be restricted. Replace salt with herbs or spices instead to flavor meals.

To reduce refined sugars, avoid serving processed foods. Baked goods made with fruit or sweetened with fruit juice are better alternatives.

Honey is also an optional sweetener.

Conclusion

Although some dementia patients tend to overeat, it is possible to better monitor what they consume and how often they do so.

If a patient has a particularly strong preference for foods that aren’t healthy which leads to insufficient consumption of other food groups, it is advised to consult with a dietitian.

Professional assistance with an eating plan will ensure good health with nutritious food and avoid excess weight gain.

References:
1. Kyoko Kai, et al. Relationship between Eating Disturbance and Dementia Severity in Patients with Alzheimer’s Disease. PLoS One. 2015; 10(8): e0133666.
2. Chia-Chi Chang, et al. Prevalence and factors associated with food intake difficulties among residents with dementia. PLoS One. 2017; 12(2): e0171770.

Dementia And Spicy Foods: Are They Related?

Dr. Muhammad Usman Blog, Signs February 23, 2021October 16, 2021dementia, dementia and eating, food, spicy foods

With the progression of dementia, taste buds weaken, making patients develop strange food cravings, even for extremely spicy foods. But is dementia and spicy foods linked increasing dementia risk?

Are Dementia And Spicy Foods Linked?

The prevalence of dementia is on the rise and numbers are expected to double every 20 years.

It appears when your brain suffers from neurological problems leading to loss of memory and poor judgment.

The decline in memory deteriorates the quality of life in the elderly and, in the long term, reduces cognitive function.

The effects of dementia, and problems happening concurrently with it, are extensive. Moreover, they do not affect the brain only.

Scientists have observed significant alterations in dietary behaviors of people suffering from dementia.

These range from the changes in appetite to unusual food cravings.

How Does Dementia Affect Eating Habits?

Dementia leads to various metabolic and psychological changes in the body. These, coupled with the weakened taste buds, change dietary preferences.

During a research study conducted by the Medical research council, the caregivers of dementia sufferers pointed out a preference for foods that are strong and savory in flavor.

Some of the eating patterns in people with dementia are:

Over-eating
Binge-eating
Decreased appetite
Changes in food choices
Pica (craving for inappropriate foods)
Pica (craving for non-food items e.g. mud)
High consumption of sugary and spicy foods

Do People With Dementia Crave Spicy Foods?

The unusual food cravings vary from person to person. Some people crave sweet foods while others incline towards spicy or salty foods.

The reason why the elderly with dementia crave spicy foods are as follows:

1. Dementia Weakens The Taste Buds

The craving is due to the disappearance of taste buds with the progression of the disease.

Humans can identify salty, sweet, sour, bitter, and umami taste.

However, dementia sufferers lose this ability with time. Dementia makes them unable to identify a particular taste as well as differentiate between two different flavors.

This is due to the loss of nerve endings in the tongue.

Since dementia appears with morbid brain conditions, it diminishes the neurological sense responsible for taste.

The elderly cannot feel the tanginess of food so, they ask for a stronger flavor. The same is true for salty foods.

2. Capsaicin Releases Endorphins

Ever wonder why spicy food burns tongue? It is due to the active ingredient present in chili, called capsaicin.

Capsaicin instigates pain receptors in the mouth and tongue, causing a burning sensation.

Due to the activation of these receptors, the brain translates it as a painful experience and floods the body with endorphins.

These are responsible for elevating mood and reducing the painful sensation.

Additionally, dopamine is released which is involved in the reward system of the brain. The result is a euphoric state called “runner’s high”.

Since such neurotransmitters are low in quantity in dementia patients, the body creates a compensatory mechanism.

It generates cravings for foods that cause endorphins to rush.

Is There Any Cultural Relation To Cravings of Spicy Foods?

Food choices vary immensely throughout the world.

This is also true for the condiments used to prepare local cuisine.

Predictably, the taste buds of natives of each region are adapted to the flavors of their local food seasonings.

Asians consume far more chili and spicy herbs in their meals as compared to westerns.

Therefore, experts think dementia sufferers from the Asian region are more likely to indulge in binge-eating spicy foods.

In such regions, the population develops a habit of using strong spices.

So, they misunderstand their lack of sense of taste in dementia as a bland and flavorless meal.

This results in an excessive intake of chili among the old age population.

Although it is more prominent in areas where spicy cuisine is widespread, westerns are also prone to such cravings.

Their chili usage is minimal but hot sauces and other herbs are still popular in Caucasians and western ethnicities. The proportion may be far lesser but they often enjoy pickles and jalapenos.

A study done in the UK showed that 15% of participants reported a likeness for spicy foods frequently after the onset of dementia.

Do Spicy Foods Increase The Incidence Of Dementia?

High spicy food intake may not be as harmful as excessive use of sweets, but it has a deeper relationship with the cause.

Scientists think that chili consumption is linked with an increased risk of dementia.

In Asia, chili is the most frequently used spice. In some regions of China, one in every three adults consumes chili daily.

It has many beneficial impacts on obesity and hypertension due to the presence of capsaicin in it. But there is more to the story.

Considering these properties, capsaicin should reduce the oxidative burden of the brain and enhance cognitive function but evidence proves the opposite.

People who consume more than 50g of chili per day experience a reduction in cognitive function.

The findings also suggested:

Twice the risk of self-reported poor memory
56% increase in the incidence of memory decline
The low global cognitive score for cognitive function
A decline in memory co-efficient with each 10g increase in chili intake
Both males and females are equally vulnerable
Less marked in overweight individuals
Those with normal or low BMI are more prone to dementia due to chili

Apart from these, spicy foods can upset the stomach and lead to long-term gastrointestinal problems.

Considering these findings, it is essential to cut back spicy food consumption in seniors in order to slow the progression of dementia.

How to Manage Spicy Food Cravings in Dementia?

1. Salty foods can replace spicy foods but they should be used with care as they increase the risk of hypertension in the elderly.

2. The senses of smell and taste are intertwined. So, preparing food with seasoning that can create a delicious aroma helps in managing cravings of spicy food without actually having a spicy meal.

3. Spices, other than chili, and herbs should be incorporated to increase the flavor of the meal.

4. Some naturally occurring spicy foods like jalapenos and pickles used as a seasoning.

Conclusion

The sense of taste diminishes and endorphin production reduces with the progression of dementia.

To overcome these troubles, the elderly often crave spicy foods. They can cause an upset stomach and even worsen dementia with time.

The decline in memory function due to chili is higher in the underweight population. To reduce this possibility, chili should be replaced with better spices and herbs.

Salty meals can be used in a controlled amount but some naturally occurring spicy products like jalapenos and pickles are better substitutes.

Dementia And Eating Issues In Patients

Rok Krivec Blog, Causes, Signs February 8, 2021October 16, 2021dealing with dementia, dementia, dementia and eating, effects of dementia

For a person with dementia, the topic of dementia and eating is important to discuss.

This is because individuals with dementia usually go through several changes; one of them being how they eat.

Below you will explore some of the common eating challenges persons with dementia face.

It is important to understand each to act accordingly.

Common Eating Challenges for Persons with Dementia

Poor Appetite

A high percentage of individuals who have dementia experience lack of appetite at some point.

There are several explanations of why individuals can lose their appetite, including:

1. Depression

It is common for people with dementia to go through depression, which can be the cause of loss of appetite.

If you notice that a loved one or person under your care has depression, talk to your doctor right away.

He or she will prescribe the ideal medication or other therapies to help treat depression.

2. Constipation

This is another problem that can make one feel nauseous and bloated; thus, feel less likely to eat.

Try and avoid constipation by making sure the person with dementia takes lots of fluid and foods that are rich in fiber. If this condition becomes worse, consult your GP.

3. Communication

An individual who has the illness may have a tough time communicating well that they are hungry or do not like the food in front of them.

Take cue of how such people try and pass the message. For instance, closing the mouth for refusing to swallow can be an indication that they do not like the food that is on the table.

You can offer food choices using pictures and prompts so that a person can enjoy what they are eating.

Other factors that can trigger loss of appetite include when a person is experiencing pain, tiredness, changes in medication, or lack of physical exercises that make one not feel hungry.

Mouth Infections

There are times when dementia and eating issues come about because a person simply cannot eat the food even when they want to.

They can have bad teeth, redness, or sores in the mouth. If this is the case, visit a dentist to get a practical solution.

Caregivers can also help by taking care of their loved ones’ dental hygiene. This includes ensuring that they brush and floss their teeth at least two times a day.

It is also advisable to serve foods that are easy to chew. Solid foods can be cut into small pieces to make them more manageable.

You may also have to seek the services of an occupational therapist if a person is having challenges moving their muscles to open the mouth.

The professionals will come up with ways to help them eat.

Insatiable Appetite

While some people with dementia will experience loss of appetite, others will want to eat non-stop.

It may be possible that they may have forgotten when they had the last meal or be afraid of where the next one will come from.

Naturally, this is not healthy as overeating also comes with its fair share of negative health issues.

To try and tackle such a situation, you can serve five-to-six small meals throughout the day.

You can also avail of low-calorie snacks like carrots and apples that the person will munch on when they feel hungry.

Remember to cut down on processed foods, refined sugars, and foods with high sodium levels.

Engaging the individuals in physical exercises or other enjoyable activities can also help to take their mind off food.

Sweet Cravings

Some individuals with dementia will all over sudden develop a sweet tooth where they are always craving something sweet to eat.

Although you can give in to their demands a couple of times, it is not right to always give them sweet foods that are not good for their health.

To manage the cravings, you can opt to try food items like egg nogs, milkshakes and low-calorie ice cream that can help satisfy the cravings without causing too much damage.

Fruit can come in handy during such times. You should also check some of the side effects that the medicine the person with dementia is on.

Some antidepressant medications can make someone crave sweets. It is also advisable to share meals with your loved ones as this might increase their chances of eating the healthy meal you provide.

Decreased Judgment

Another factor that may contribute to dementia and eating problems in an individual is decreased judgment.

This is where a person with dementia may not be able to know what food items are on their plate or what to do with the cutlery before them.

You may notice that a person tries to eat from a cup rather than a plate.

Some may even use knives to try and pick up food instead of a spoon or fork.

To help with such, you can cue the person with actions or words so that they can mimic the effects of eating like putting food on a spoon and taking it to the mouth.

If the person is still struggling, be respectful and ask if they need assistance and go-ahead to offer a hand in a way that does not make them feel less of a person.

You can also serve finger foods that do not require utensils to consume like sandwiches and miniature quiches.

Swallowing Difficulties

Some patients with dementia will experience Dysphagia, where they have difficulties swallowing food.

This can come about as a result of the changes that occur in the brain.

Environmental changes like noisy dining rooms can also make one experience difficulties while swallowing.

You must be very careful with this because it can cause further problems like choking, poor nutrition, aspiration where food goes down the wrong way in the lungs, and reduced life quality.

To give assistance, it is vital to create a comfortable and relaxed eating environment where a person will be at ease.

You can also use contrasting colored cutlery and plates so that the individual can easily see the food.

It may also help to offer small food amounts so that they can swallow without too much difficulty.

Softer textured food might also be an option as it is easy to chew and swallow.

A speech and language therapist can help when you feel like the swallowing issue is getting out of hand.

Agitation and Irritability

During mealtimes, a person with dementia may experience behavior changes where one becomes angry, agitates, or irritable.

These can manifest in different ways like spitting out food, throwing away the food, or simply refusing to eat.

Before you dismiss the individual, try and find out why they are acting this way.

Some possible reasons for this behavior changes may include:

The food is too hot
A person does not like what is on the table
They are frustrated by the eating difficulties they are facing
Rushed eating
They do not like the eating area or the people around
They want assistance eating, etc.

When faced with such a scenario, remember to be as calm as possible so that it does not escalate and become worse. Never put pressure or rush a person as they eat.

You can also take the food away and wait for them to cool down before offering something to eat or drink.

It is also important to try and read body language to pick up clues on what the person wants.

You should also note that this is not the time for criticism and nagging. Offer plenty of support keeping in mind that the individual may not be in control of how they react.

They act the way they do because of the changes that happen in their brain because of the memory-loss disease.

Declining Motor and Visual Abilities

In regards to dementia and eating problems, the individual with the illness may experience a decline in motor and visual abilities as the disease progresses.

He or she may have a difficult time trying to comprehend where some objects concerning each other.

This often affects co-ordination and movement, which can cause problems when a person is eating.

Some helpful tips that can make things a lot easier for the person with dementia include offering colorful foods that are easily distinguishable.

You may also want to avoid the use of paper napkins or Styrofoam cups that a person might eat by mistake.

Store away the fragile China porcelain and do not place sharp knives on the table. It is also recommended to offer one food at a time to avoid overwhelming the person with dementia.

Closing Thought

Eating well is essential for anyone who has dementia if they want to stay healthy. A balanced diet is key to enhancing the quality of life. Not eating enough makes you prone to unhealthy weight loss, lower muscle strength, higher risk of infection, and a myriad of other health problems.

For people with dementia, it is vital to work closely with a dietician who will advise on the best foods to consume at every stage of the illness.

You should also note that each person’s dementia and eating journey is unique. For this reason, it also helps to take into account an individual’s culture, history, beliefs, and preference when coming up with diet plans.

This will help you to tailor appropriate eating solutions that will meet their preferences and nutritional needs.

Why Do Dementia Patients Stop Eating?

Dr. Muhammad Usman Blog February 7, 2021October 16, 2021dementia, dementia and eating, food

There are multiple reasons why do dementia patients stop eating and it is important to understand why they may start to avoid food.

Dementia patients might refuse to eat if they either dislike the food or are trying to tell you their meal is too hot or too cold.

They may not even know that they should chew and swallow it.

Patients diagnosed with dementia will experience a decline in their memory as well as problem-solving and other thinking-related skills.

Alzheimer’s disease is the most common type of dementia and as many as 50 percent of these individuals find it difficult to eat at some point during their disease (1).

It becomes increasingly difficult for affected patients to perform normal daily activities. For this and other reasons, patients with dementia will spit out their food or stop eating entirely.

What Causes A Dementia Patient To Stop Eating? – 4 Factors to Consider

The global statistics for dementia are mind-boggling. As of 2017, the total number of people with dementia was estimated to be 50 million.

This number is expected to rise to 75 million by 2030. Furthermore, in the US alone, one in three elderly people dies from Alzheimer’s or another form of dementia.

These increasing numbers of cases bring with them increasing challenges.

Feeding such patients is indeed one of the biggest challenges.

Poor nutrition increases the risk of dehydration, muscle loss, higher chances of infection, a decline in the overall well-being, and even death (4).

In the seven stages of Alzheimer’s a patient moves from their dementia being barely detectable to an extremely severe, steady, and visible decline (5).

It’s not abnormal for Alzheimer’s patients to stop eating or drinking in the later stages of their diagnosis.

Approximately 50 percent of diagnosed Alzheimer’s patients won’t eat enough food or drink sufficient fluids (1). The resulting weight loss develops into a larger problem as their disease progresses.

As per research, following are the four main reasons dementia patients stop eating and drinking as their disease progresses.

1. Dementia Affects Brain Areas Associated With Swallowing

Inability to swallow food is termed as dysphagia. The prevalence of dysphagia among elderly can be as high as 40 percent. This percentage is even higher among people with dementia (6).

But why is that?

Different types of dementia eventually lead to the shrinkage of the parts of the brain that coordinate swallowing. Consequently, the patients find it extremely hard to swallow as their disease progresses.

2. They are Unable to Communicate Their Hunger Effectively

Dementia patients may also not be able to effectively communicate their hunger or the fact that they don’t like the food they’re eating.

3. Their Interest Changes and They Might Forget What They Used to Like

Also, a patient’s appetite and interest in food could change. They may not taste food or experience flavor as they did before (7).

As people age, their taste buds diminish. It’s common for dementia patients to prefer eating heavy or flavor-filled foods, such as sugary sweets for snacks.

4. Their Eating Habits Might be Affected By Physical and Mental Well-Being

On top of the above, dementia patients could refuse to eat because they feel constipated, depressed, lonely, lethargic, or sore.

Appetite loss could also be a possible side effect of medication (7).

How to Help a Dementia Patient Eat?

If a dementia patient refuses to eat, it’s important to ensure they’re well hydrated. Dehydration is a cause of appetite loss. It’s also possible for elderly patients not to be sufficiently hydrated.

Because of this, they become dehydrated quicker and easier because of their age, body changes, or medication they’re taking.

Drinking water might be too plain and met with resistance. It’s useful to offer patients a soft, liquid meal such as cereal or soup instead.

Taking a look at the patient’s mouth will also reveal any redness or swelling that could cause a lack of interest in eating. A dental appointment could help to address any such concerns.

Some ways to encourage a dementia patient’s appetite include:

Setting up a daily meal routine

This assists the patient’s body with feeling more ready to eat at fixed times.

Offering the patient their favorite food

They may be more likely to eat something familiar that they recognize and love.

Giving the patient a choice of food

Using prompts or pictures may help patients show you what they’d like to eat or drink.

Making their food look, smell and taste as tempting as possible

Patients are more likely to show interest in food that catches their attention.

Involving the patient in meal preparation

A patient may be more willing to eat if they’ve helped prepare the food.

Trying various types and textures of food or drinks

Milkshakes, smoothies, jelly, naturally soft foods, and puréed vegetables are all easier to chew & swallow.

What Happens in The Last Stage of Dementia?

A patient could spend between approximately one and three years in the last severe stage of Alzheimer’s. Approximately 1.8 million US adults are in the final stages of dementia at the time of writing.

As the disease progresses, a patient can do less. They become increasingly dependent on others for assistance.

Eating and swallowing become more difficult during this stage. Sometimes patients won’t eat because they aren’t hungry or they’re simply confused.

Around the clock hospice care is usually administered to such patients.

How Long Can A Dementia Patient Live Without Eating?

When a dementia patient is no longer consuming fluids, and particularly if they’re bedridden, they may only live between a few days or at most a few short weeks.

Generally, when a patient is in the dying process they lose their appetite and sense of thirst.

While people can generally survive longer without eating than they would without drinking, a bedridden patient who’s not consuming sufficient food or drink in this last stage is unlikely to survive.

Are There Any Exceptions?

While some dementia patients eat too little, others overeat. Some dementia patients may eat too much food at a time or consume meals too often.

Patients suffering from behavioral variant frontotemporal dementia are more prone to overeating.

It’s also possible for patients to demonstrate excessive eating and other related eating behavioral changes because of changes in their dietary preferences.

They may even be obsessed with certain foods.

Conclusion

While many dementia patients do stop eating as their condition worsens, it’s possible to attempt to make their mealtimes more enjoyable.

Such patients may be more inclined to eat and drink if their mealtime is accompanied by activity and social stimulation.

By having some nostalgic conversations over a plate of food they may also be more inspired to eat or drink, and in turn, stay well-nourished and hydrated.

References
1. Chia-Chi Chang, et al. Prevalence and factors associated with food intake difficulties among residents with dementia. PLoS One. 2017; 12(2): e0171770.
4. Jansen S, Ball L, Desbrow B, Morgan K, Moyle W, Hughes R. Nutrition and dementia care: Informing dietetic practice. Nutr Diet. 2015;72(1):36–46.
5. Craig J. Thalhauser, et al. Alzheimer’s disease: rapid and slow progression. J R Soc Interface. 2012 Jan 7; 9(66): 119–126.
6. Livia Sura, et al. Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging. 2012; 7: 287–298.
7. Suski NS, et al. Factors affecting food intake of women with Alzheimer’s type dementia in long-term care. J Am Diet Assoc. 1989 Dec;89(12):1770-3.