Updated advice on eating and drinking for a person with dementia

Helping a person with dementia to maintain a healthy diet can be difficult for the people caring for them. This newly updated leaflet from Dementia UK aims to provide some positive tips on ways to help.

People with dementia may experience problems with eating and drinking. There are many reasons this might happen. They might:

  • forget to eat or drink
  • experience difficulties preparing food or drinks
  • have difficulty recognising food items
  • have a change in appetite or taste

Eating a healthy and balanced diet is important for a person’s physical and mental health. Not eating and drinking enough can increase the risk of dehydration, weight loss, a urinary tract infection and constipation. These health problems can be particularly problematic for someone with dementia as they can increase confusion and the risks of delirium, and sometimes make the symptoms of dementia worse.

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This leaflet aims to provide some positive tips on ways to help including:

  • Setting the scene for mealtimes: A familiar, sociable environment can help a person with dementia to feel more comfortable eating and drinking
  • Encouraging a person with dementia to eat: Involve the person by asking them what they would like to eat. If they struggle to decide, you could give them two options of simple things you know they like and can manage. If appropriate, you could involve them in the food preparation
  • Encouraging a person with dementia to drink: A person with dementia may not always be able to recognise when they are thirsty, or they might not be able to communicate their thirst. But nevertheless, it is recommended to aim for about eight glasses of fluid per day
  • Stocking up and storing food: A person with dementia might need help keeping track of what food they have at home and storing food safely
  • Weight gain or weight loss: Some of the eating and drinking issues associated with dementia can lead to weight loss. Pureed food is less nutritious, and people with dementia are at risk of malnutrition.

Full leaflet: Eating and Drinking. Staying well with dementia | Dementia UK

Alzheimer’s study to look at gut health link

University of Aberdeen | December 2018 | Alzheimer’s study to look at gut health link

A new study led by experts at the University of Aberdeen will recruit patients in the local are to its study which will determine if there is a link between diet in managing the behavioural and psychological symptoms of the disease. 

There is increasing evidence that suggests the gut microbiota is a key link between specific nutrients and brain function.

The study will collect samples from three groups of people: people with dementia and challenging behaviour; people with dementia without challenging behaviour; and a control group of people without dementia.

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Professor Alex Johnstone from the University of Aberdeen said:

“This study is the first of its kind and could lead to the possibility of dietary intervention as a solution to prevent behavioural and psychosocial issues which are associated with adverse outcomes as well as distressing to people with dementia, their family and carers.

“We want to explore whether or not the gut-brain axis plays a key role in behavioural changes in dementia.” (Source: University of Aberdeen)

For further details of this study read the release from University of Aberdeen

Interventions maintaining eating independence in nursing home residents

Palese, A. et al. | Interventions maintaining eating Independence in nursing home residents: a multicentre qualitative study | BMC Geriatrics | 2018 18:292 | published online 27 November 2018

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Background
Despite 32 years of research and 13 reviews published in the field, no intervention can be considered a gold standard for maintaining eating performance among residents with dementia. The study aim was to highlight the interventions derived from tacit knowledge and offered daily in assisting eating by healthcare professionals (HCPs) in nursing homes (NHs).

Method
A multicentre descriptive qualitative study was performed in 2017. Thirteen NHs admitting residents with moderate/severe functional dependence in eating mainly due to dementia, were approached. A purposeful sample of 54 HCPs involved on a daily basis in assisting residents during mealtime were interviewed in 13 focus groups. Data analysis was conducted via qualitative content analysis.

Results
The promotion and maintenance of eating performance for as long as possible is ensured by a set of interventions targeting three levels: (a) environmental, by ‘Ritualising the mealtime experience by creating a controlled stimulated environment’; (b) social, by ‘Structuring effective mealtime social interactions’; and (c) individual, by ‘Individualising eating care’ for each resident.

Conclusions
In NHs, the eating decline is juxtaposed with complex interventions regulated on a daily basis and targeting the environment, the social interactions, and the residents’ needs. Several interventions that emerged as effective, according to the experience of participants, have never been documented before; while others are in contrast to the evidence documented. This suggests the need for further studies in the field; as no conclusions regarding the best interventions have been established to date.

Full document: Interventions maintaining eating Independence in nursing home residents: a multicentre qualitative study

Eating and drinking for a person with dementia

Helping a person with dementia to maintain a healthy diet can be difficult
for the people caring for them. This leaflet aims to provide some positive
tips on ways to help | Dementia UK

People with dementia may experience problems with eating and drinking.
There are many reasons this might happen. They might:

  • forget to eat
  • experience difficulties preparing food
  • have difficulty recognising food items
  • have a change in appetite or taste
eating dementia
Image source: http://www.dementiauk.org

Eating a healthy and balanced diet is important for a person’s physical and mental health. Not eating and drinking enough can increase the risk of dehydration, weight loss, a urinary tract infection and constipation. These health problems can be particularly problematic for someone with dementia as they can increase confusion and the risks of delirium, and sometimes make the symptoms of dementia worse.

This leaflet from Dementia UK provides useful tips on the following:

  • Setting the scene for mealtimes
  • Encouraging a person with dementia to eat
  • Encouraging a person with dementia to drink
  • Stocking up and storing food
  • Weight gain or weight loss
  • Swallowing

Full resource: Eating and drinking: Staying well with dementia

Related:   ‘Eating and Drinking Well: Supporting People Living with Dementia’ |Bournemouth University

Current evidence on diet, cognitive impairment and dementia.

The Scientific Advisory Committee on Nutrition (SACN) position statement on current evidence on diet, cognitive impairment and dementia.

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This position statement by SACN provides an overview of the currently available evidence on nutrition and cognitive impairment and dementia (including Alzheimer’s disease) in adults. It considers evidence relevant to the prevention – not the treatment – of cognitive impairment or dementia.

The position statement concludes that:

  • the evidence base in this area is very limited
  • there is no evidence that specific nutrients or food supplements affect the risk of cognitive impairment or dementia
  • there is some observational evidence that greater adherence to a Mediterranean dietary pattern may be associated with reduced risk of mild cognitive impairment and dementia

While there is no single Mediterranean diet, such diets tend to include higher intakes of vegetables, fruit, legumes, cereals, fish and monounsaturated fatty acids; lower intakes of saturated fat, dairy products and meat; and a moderate alcohol intake. Mediterranean type diets broadly align with current UK healthy eating recommendations as depicted in the Eatwell Guide (PHE, 2016).

Full document: SACN statement on diet, cognitive impairment and dementias

You can find more information about SACN online.

Sugary beverage intake and preclinical Alzheimer’s

Excess sugar consumption has been linked with Alzheimer’s disease (AD) pathology in animal models | Alzheimers & Dementia

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We examined the cross-sectional association of sugary beverage consumption with neuropsychological (N = 4276) and magnetic resonance imaging (N = 3846) markers of preclinical Alzheimer’s disease and vascular brain injury (VBI) in the community-based Framingham Heart Study. Intake of sugary beverages was estimated using a food frequency questionnaire.

Relative to consuming less than one sugary beverage per day, higher intake of sugary beverages was associated with lower total brain volume (1–2/day, β ± standard error [SE] = −0.55 ± 0.14 mean percent difference, P = .0002; >2/day, β ± SE = −0.68 ± 0.18, P < .0001), and poorer performance on tests of episodic memory (all P < .01). Daily fruit juice intake was associated with lower total brain volume, hippocampal volume, and poorer episodic memory (all P < .05). Sugary beverage intake was not associated with VBI in a consistent manner across outcomes.

Higher intake of sugary beverages was associated cross-sectionally with markers of preclinical AD.

Full reference: Pase, M.P. et a; (2017) Sugary beverage intake and preclinical Alzheimer’s disease in the community. Alzheimers & Dementia. Vol. 13 (Issue 9) pp. 955–964.

The association between an inflammatory diet, cognitive function and dementia

The Mediterranean and Dietary Approaches to Stop Hypertension diets have been associated with lower dementia risk. We evaluated dietary inflammatory potential in relation to mild cognitive impairment (MCI)/dementia risk | Alzheimer’s & Dementia

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Method: Baseline food frequency questionnaires from n = 7085 women (aged 65–79 years) were used to calculate Dietary Inflammatory Index (DII) scores that were categorized into four groups. Cognitive function was evaluated annually, and MCI and all-cause dementia cases were adjudicated centrally. Mixed effect models evaluated cognitive decline on over time; Cox models evaluated the risk of MCI or dementia across DII groups.

Results: Over an average of 9.7 years, there were 1081 incident cases of cognitive impairment. Higher DII scores were associated with greater cognitive decline and earlier onset of cognitive impairment. Adjusted hazard ratios (HRs) comparing lower (anti-inflammatory; group 1 referent) DII scores to the higher scores were group 2-HR: 1.01 (0.86–1.20); group 3-HR: 0.99 (0.82–1.18); and group 4-HR: 1.27 (1.06–1.52).

Conclusions: Diets with the highest pro-inflammatory potential were associated with higher risk of MCI or dementia.

Full reference: Hayden, K.M. et al. (2017) The association between an inflammatory diet and global cognitive function and incident dementia in older women: The Women’s Health Initiative Memory Study. Alzheimer’s & Dementia. Published online: May 19 2017