Nutrition Concerns for Individuals with Dementia

By Barbara Gordon, RDN, LD
Man being served

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Individuals with dementia experience forgetfulness and memory loss. They may also have personality changes and impaired thinking. Many people with dementia do not follow a special diet. However, it's not uncommon for people with dementia to struggle to maintain a healthy body weight.

Eating Challenges with Dementia

Weight loss is common and tends to become more severe as dementia gets worse. In addition to simply forgetting to eat, there are other reasons weight loss might occur:

  • Appetite triggers in the brain may not be working normally or medications may impact the desire to eat.
  • Food may taste bland due to changes in sense of smell and taste.
  • Difficulty focusing may cause an individual to spend less time eating and therefore consume fewer calories.
  • Coordination skills might decline, making use of eating utensils or feeding oneself difficult.
  • Chewing and swallowing problems can make it difficult to eat. Some individuals may be prescribed diets that include softer foods to help encourage intake or thickened liquids for easier swallowing.

With severe dementia, individuals may also lose the ability to distinguish food from non-food objects. This might lead to replacing food intake with items that can't be digested or may even be toxic.

Healthy Eating for Individuals with Dementia

Though the Internet is flooded with information on how various vitamins and minerals can help prevent or even reverse dementia, at this time the research is limited. However, if an individual has a vitamin or mineral deficiency, a supplement may be recommended. Some vitamin deficiencies are associated with memory problems and improve after they've been diagnosed and treated.

The research on specific foods and eating patterns for reversing dementia is limited. However, there is some research that suggests certain eating patterns may play a role in preventing or delaying the onset of dementia. The Mediterranean diet, DASH diet and MIND diet have all been studied for its role in prevention of dementia with some promising results. At this time, more research is needed to understand the preventative effects of these diets.

The goal for most individuals with dementia is to eat a variety of foods needed for good nutrition status. For individuals who may be on a special diet for other health conditions such as diabetes or high cholesterol, health care providers may lift these restrictions to promote better overall intake. As dementia worsens, some individuals may require more calories because of increased activity. Oral nutrition supplements are often recommended to help get the calories and nutrients needed to maintain weight.

As we age our thirst sensation decreases. Add this to the other challenges of dementia and individuals may also be at an increased risk of dehydration. Encouraging fluid intake and providing foods that are rich in water, such as fruits and vegetables, can also help.

Many individuals with dementia may be unable to shop for or prepare food. They may need a caregiver to help with these tasks. When shopping, select foods that the individual enjoys eating, keeping in mind cultural and religious food preferences.

Mealtimes are also an important part of ensuring an individual with dementia gets enough to eat. Serving meals at a kitchen or dining table can help them focus on the task of eating. Individuals with dementia can become easily distracted, so avoid using patterned plates, having too many items on the table and turn off the television during meals. Eating with others in a family-style setting may help them to focus on eating and increase how much they eat.

As the memory loss worsens, caregivers may also need to provide verbal prompts to encourage individuals to eat. Bite-sized finger foods may encourage eating because they do not require utensils. Modified food textures are also commonly prescribed, since they can be easier to chew and swallow.

The Healthcare Team

As dementia progresses, other forms of assistance with meals may be needed. Be sure to discuss any changes in eating or drinking habits with a health care provider. Members of the health care team, including registered dietitian nutritionists, speech language pathologists and occupational therapists are skilled in helping individuals with dementia and their caregivers. RDNs assess a patient's nutrient needs and develop an individualized eating plan that takes into account personal food preferences and abilities. A referral to an RDN can be provided by a physician. Use the Find an Expert tool to locate an RDN in your area.

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