Although the loss of appetite may be common in the elderly, for persons with dementia it can bring additional challenges.
Loss of appetite is common in the elderly due to changes in the brain.
Familiar foods or traditional foods often improve appetite in persons with dementia.
In persons with dementia, along with other changes in the brain, an impaired sense of smell and swallowing disturbances cause appetite loss.
Loss of appetite can lead to unintended weight loss and malnourishment. When the body does not receive adequate nutrients, behavioral symptoms associated with dementia increase.
What causes loss of appetite?
Loss of appetite is a common symptom observed in older adults. Several physiological changes are responsible for causing the loss of appetite. Taste perception declines over time as taste buds degenerate. For older adults without natural teeth, chewing food may be harder, which also affects taste perception.
Persons with dementia also have an impaired sense of smell. This can make food less appetizing. Eating and swallowing disturbances are often observed in those with dementia. If these symptoms are left unattended, your loved one may experience further deterioration in their health.
Other associated symptoms
In the early stages of dementia, you may not notice any loss of appetite symptoms. But as the disease progresses, up to 81% of people with dementia experience eating disturbances.
- Appetite. You may notice a stronger or weaker appetite.
- Swallowing. People with dementia often have difficulty swallowing liquids and solids. In vascular dementia, patients also run a high risk of aspiration pneumonia due to swallowing disturbances.
- Coughing. People may cough and choke when they put food in their mouth.
- Not chewing. You may notice your loved one place food in the mouth without chewing it.
- Sweet-tooth. People with dementia often show a preference for sweet items such as candy.
- Depression. Loss of interest in food can lead to signs of depression such as sadness, anger, sleep disturbance and tiredness.
- Strong flavors. Your loved one might show a preference for strong flavored foods such as soy sauce.
- Changes. They may suddenly want to eat new foods. For example, eating meat after years of being vegetarian.
- Drinking. Your loved one might start showing a preference for alcohol or soft drinks. Drinking too much or too little water is common.
Families often find such situations difficult to deal with, but usually come up with creative solutions.
Encourage a dementia patient to eat
Maintaining healthy nutrition is the key to preventing cognitive decline in your loved one with dementia. If your loved one is living alone, then ensure that food is available by signing up for grocery delivery services or programs. Also, check intermittently that they have eaten their food and set reminders such as a clock alarm if needed.
Due to the loss of appetite, eating food becomes a boring experience. You can help your loved one to make eating an enjoyable activity by enhancing flavors. Various herbs such as garlic, rosemary, cilantro, or lavender can add more flavor to food. Seasoning with spices such as cumin, turmeric, or cinnamon can further enhance various dishes.
If you live with your loved one with dementia, then you can encourage them to eat healthily. Although your loved one may crave sugar, in the early stages of dementia reducing sugar or replacing it with healthier options such as fruits is recommended.
As the disease progresses, adding honey or syrup to deserts might become necessary for a sweet taste. Always ask your loved one with dementia about their preference for food and try to accommodate those wishes. For instance, if your loved one requested meat but has been vegetarian all their life, then offer plant-based “meats”.
Some persons with dementia show a decline in table manners. For instance, forgetting the use of cutlery and eating with hands, eating with a mouth too full, sucking food items without swallowing them, or eating non-edible items such as bottle caps, and napkin holders. In such a situation, gentle reminders are helpful to finish the meal.
Eating as an enjoyable activity
Usually, your loved one with dementia will not need a special diet, but will need ways to make eating more enjoyable.
- Time. Allowing more time for meals, providing names of food, and offering one food item at a time helps in reducing confusion.
- Color. Altered visual abilities can also cause difficulties in eating. Instead of placing white bowls on white table mats, consider using contrasting colors.
- Technology. If the disease has advanced and your loved one is not able to eat by themselves due to tremors, then consider using assistive technology such as a smart spoon or spill-proof spoon.
Whenever possible, have meals together with your loved one with dementia. Social engagement improves eating, and your presence can help them eat better. If your loved one is experiencing a loss of appetite, talk to your care team to discuss your situation.
- Diseases. Appetite, Metabolism and Hormonal Regulation in Normal Ageing and Dementia.
- Alzheimer's Association. Food and Eating.
- Alzheimer's Society. Changes in Eating Habits and Food Preference.
- PLoS One. Relationship Between Eating Disturbance and Dementia Severity in Patients with Alzheimer's Disease.