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

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.

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

Adequate vitamin D status in older age could delay or prevent the onset of dementia

Feart, C. et al. Associations of lower vitamin D concentrations with cognitive decline and long-term risk of dementia and Alzheimer’s disease in older adults, Alzheimer’s & Dementia | Published online: 15 May 2017

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Introduction: Hypovitaminosis D has been associated with several chronic conditions; yet, its association with cognitive decline and the risk of dementia and Alzheimer’s disease (AD) has been inconsistent.

Discussion: This large prospective study of French older adults suggests that maintaining adequate vitamin D status in older age could contribute to slow down cognitive decline and to delay or prevent the onset of dementia, especially of AD etiology.

Read the full abstract here

Expert reaction to artificially-sweetened fizzy drinks, stroke and dementia

A new prospective cohort study publishing in Stroke investigates if there is an increased risk of stroke and dementia after sugar and artificially sweetened beverage consumption | Science Media Centre

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Dr James Pickett, Head of Research at Alzheimer’s Society said:

“This research does not show that artificially sweetened drinks cause dementia. But it does highlight a worrying association that requires further investigation

“Research into dietary factors is very complex and there are a number of issues that need clarifying, for example why drinks sweetened with sugar were not associated with an increased risk in this study, and teasing out links between all types of sugary drinks, diabetes and dementia.

“What we do know is that the things we eat and drink can have an effect on our brain health. Evidence shows that along with eating a healthy diet, including watching what you drink, the best way to reduce your risk of dementia is to take plenty of exercise and stop smoking.”

Read other expert analysis here

The original research article is available for download here

Daily consumption of tea may protect the elderly from cognitive decline

Tea drinking reduces the risk of cognitive impairment in older persons by 50 per cent and as much as 86 per cent for those who are genetically at risk of Alzheimer’s, new research suggests | ScienceDaily

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The longitudinal study involving 957 Chinese seniors aged 55 years or older has found that regular consumption of tea lowers the risk of cognitive decline in the elderly by 50 per cent, while APOE e4 gene carriers who are genetically at risk of developing Alzheimer’s disease may experience a reduction in cognitive impairment risk by as much as 86 per cent.

The research team also discovered that the neuroprotective role of tea consumption on cognitive function is not limited to a particular type of tea — so long as the tea is brewed from tea leaves, such as green, black or oolong tea.

Read the full commentary here

Read the original research article here

Nutrition and dementia care

Murphy, J L et al. | Nutrition and dementia care: developing an evidence-based model for nutritional care in nursing homes | BMC Geriatrics. | DOI: 10.1186/s12877-017-0443-2 | Published: 14 February 2017

Background: There is a growing volume of research to offer improvements in nutritional care for people with dementia living in nursing homes. Whilst a number of interventions have been identified to support food and drink intake, there has been no systematic research to understand the factors for improving nutritional care from the perspectives of all those delivering care in nursing homes. The aim of this study was to develop a research informed model for understanding the complex nutritional problems associated with eating and drinking for people with dementia.

Methods: We conducted nine focus groups and five semi-structured interviews with those involved or who have a level of responsibility for providing food and drink and nutritional care in nursing homes (nurses, care workers, catering assistants, dietitians, speech and language therapists) and family carers. The resulting conceptual model was developed by eliciting care-related processes, thus supporting credibility from the perspective of the end-users.

Results: The seven identified domain areas were person-centred nutritional care (the overarching theme); availability of food and drink; tools, resources and environment; relationship to others when eating and drinking; participation in activities; consistency of care and provision of information.

Conclusions: This collaboratively developed, person-centred model can support the design of new education and training tools and be readily translated into existing programmes. Further research is needed to evaluate whether these evidence-informed approaches have been implemented successfully and adopted into practice and policy contexts and can demonstrate effectiveness for people living with dementia.

Probiotics For the Alleviation of Symptoms in Advanced Alzheimer’s Disease?

Dementia and Elderly Care News. Published online: 14 November 2016

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Via Dementia and Elderly Care News

Iranian researchers appear to have discovered minor improvements in the symptoms of elderly people with severe Alzheimer’s Disease, associated with the regular consumption of probiotic drinks. The effects of probiotics on biomarkers for inflammation and metabolism were also investigated. More research is required before drawing firm conclusions.

Read the NHS Choices overview here

Read the original research article here