Dementia is a condition associated with a decline in the functional abilities of the brain. Patients with dementia suffer progressive problems with memory, language, understanding and judgment.  Often, but not always, the condition is associated with ageing becoming more common in patients over the age of 65. There are different types of dementia which effect different parts of the brain including Alzheimer’s disease which results from the formation of protein plaques around brain cells disrupting brain functioning, Vascular dementia where blood circulation fails to reach all parts of the bran, Frontotemporal dementia where the frontal and temporal lobes of the brain begin to shrink and dementia with Lewy bodies where abnormal structures called Lewy bodies start to develop in the brain.


Medical diagnosis and Treatment

Dementia can be difficult to diagnose especially in the early stages as many of the symptoms such as confusion and personality changes can be caused by other conditions. To confirm a diagnosis a doctor will take a thorough medical and social history and assess mental abilities e.g. through a memory/ recall test.  Imaging scans such as a CT scan or MRI scan can also be used to look for any brain abnormality.

Unfortunately there is currently no cure for dementia and symptoms become progressive with time. Although there are treatments which can help people to cope better with their symptoms and improve quality of life. Examples include individual and group therapies using exercises designed to improve memory, problem solving skills, language and behaviour.

Drug treatments may also be used depending on the type of dementia and presenting symptoms e.g. Acetylcholinesterase inhibitors are used to reduce behavioural problems in Alzheimer’s disease and work by preventing the breakdown of the neurotransmitter Acetylcholine.

Dietary management of dementia

Some research has shown possible benefits of diet in preventing the development of some forms of dementia- especially linking diets rich in antioxidants, unsaturated fats and B vitamins with a reduced risk of developing Alzheimer’s disease. In terms of treatment, People with dementia can experience a number of different nutritional problems here we shall consider two common problems- overeating and under eating and provide advice for both scenarios.

Over eating

Overeating can be a problem effecting patients with dementia and can result from a number of factors e.g. patients overeating because they have forgotten when they last ate, eating more sweet foods due to taste changes or from eating out of boredom or depression. Overeating can cause significant weight gain and increase mobility problems as well as the likelihood of other conditions associated with obesity such as diabetes and heart disease. Management of overeating will include all the advise provided in chapter 2 regarding the promotion of healthy eating. Other tips include limiting access to sweets and high fat/ sugar snack foods ensuring healthy options are available, serving healthy snacks as finger foods and planning activities for patients with dementia to help improve mood and reduce boredom associated overeating.

Under eating

Under eating can result from the aging process itself or can be attributed to the effects of dementia e.g. it may be result from depression about the diagnosis or from memory problems causing a person to forget to eat or forget how to prepare foods. Physical problems affecting the mouth can also reduce intake and drug treatments used to treat dementia/ related symptoms can also reduce appetite.

The following advice may help to treat a dementia patient who under eats:

  • Check for physical problems such as sore gums, tooth decay or ill fitting dentures- access a dentist as required.

  • Check medications with a patient’s doctor/ pharmacist to see if any are affecting appetite which could be altered.

  • Ensure that any foods prepared are appetizing in terms of colour and flavour. A patient may also respond positively to being offered small portions of food more frequently across the day as one large meal can be off putting.

  • Try to limit choice of foods at one sitting as too many options can be confusing

  • Try to prompt a patient to eat and drink foods and snacks at appropriate intervals

  • For cases of severe dementia it may be easier to serve finger foods or provide easy to use crockery and utensils such as plates on a non slip mat, knives and folks with large handles and cups with lids or straws.
These are notes from an ebook on Therapeutic Nutrition by staff of the school. To find out more, click on the image below:
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