Dementia Effect on Appetite
Changes in eating habits are common in those living with dementia. The dementia effect on appetite can be complex and distressing, impacting overall health, quality of life and wellbeing. Understanding how dementia alters eating behaviour can help families, carers and healthcare professionals support individuals to maintain good nutrition and hydration, ensuring comfort and peace of mind at every stage of the condition.
How Does Dementia Affect Eating Habits and Appetite?
One of the first noticeable symptoms can be a significant change in appetite. In some cases, there is an increased interest in food, particularly sweet foods, while in others, there is a marked decline.
These changes can stem from multiple factors, including:
- Physical difficulties, such as problems with chewing or swallowing
- Cognitive decline, leading to forgetfulness around meals or confusion about how to eat
- Mood changes, including depression and anxiety, which can suppress appetite
- Alterations in sensory perception, such as diminished taste or smell
Exploring how dementia affects eating habits and appetite is vital to ensuring nutritional needs are met and to minimising health risks associated with poor intake.
Dementia and Appetite Loss
Dementia and appetite loss often go hand in hand. As the disease progresses, individuals may simply forget to eat, lose the ability to recognise hunger, or no longer understand what food is for.
Additional factors that contribute to appetite loss include:
- Depression, commonly coexisting with dementia
- Loss of taste and smell, making food seem bland or unappealing
- Physical discomfort, such as dental issues or digestive problems
Carers must be alert to the subtle signs of appetite loss, which can include:
- Reluctance to come to the dining table
- Prolonged periods of food left untouched on the plate
- Frequent comments that food tastes bland or unpleasant
Eating Behaviour Changes
Eating behaviour changes are multifaceted. Some individuals may eat excessively or fixate on specific foods, while others may struggle with using cutlery, leading to frustration or embarrassment at mealtimes.
Common behavioural changes at mealtimes may include:
- Eating with fingers rather than using utensils
- Grabbing food from others’ plates
- Refusing to sit down for meals
- Becoming agitated or distracted during mealtimes
These behaviours are not acts of rudeness; they are symptoms of the neurological changes caused by the disease. Gentle redirection, adapting meal settings and maintaining a calm environment can all support more positive dining experiences.
Dysphagia in Dementia
Another crucial aspect of the dementia effect on appetite is dysphagia in dementia, or difficulty swallowing. This can make eating and drinking not only challenging but dangerous, with a risk of choking or aspiration pneumonia. Dysphagia often results in a fear of eating, as individuals become anxious about the discomfort or danger associated with swallowing.
Speech and language therapists can provide invaluable support through swallowing assessments and the introduction of modified textures, such as puréed or soft foods, to help maintain safe eating for as long as possible.
Dementia and Hydration Issues
Adequate fluid intake is essential to health, yet dementia and hydration issues are common. Individuals may not feel thirst, forget to drink, or be unable to communicate their need for fluids. Dehydration can exacerbate confusion, lead to urinary tract infections, and increase the risk of falls.
Offering drinks little and often, and incorporating hydrating foods like fruits and soups into meals can assist in addressing hydration needs. Creating a supportive environment where fluids are readily available and accessible at all times is key.
Sensory Changes in Eating
Sensory changes in eating are significant contributors to altered eating habits. Dementia can dull the taste and smell senses, leading to disinterest in food. In some cases, individuals may perceive tastes differently, sweet flavours may become more appealing, while savoury or bitter foods may seem unpleasant. Changes in vision can also affect the ability to distinguish food on a plate, making meals confusing or overwhelming.
Enhancing flavours, using contrasting colours between plates and food, and reducing distractions at mealtimes can help to overcome these sensory barriers.
Food Refusal Dementia
Food refusal dementia is a difficult and emotional challenge. Individuals may push food away, turn their heads, or keep their mouths firmly closed. They might no longer recognise food as something to be eaten or could be experiencing physical discomfort such as mouth ulcers, ill-fitting dentures, or undiagnosed infections.
Patience, observation and offering preferred foods can sometimes overcome food refusal. In some cases, more specialised interventions are needed, such as consulting a dietitian or doctor to rule out treatable causes.
Swallowing Difficulties Elderly
While swallowing difficulties in the elderly can occur without dementia, they are particularly prevalent among those with the condition. As swallowing becomes impaired, the risk of malnutrition, dehydration and choking rises. Carers should be aware of signs such as coughing during meals, a wet-sounding voice after eating, or repeated chest infections.
Adopting appropriate food textures and positioning strategies during meals, alongside professional input, can prolong safe swallowing and support nutrition.
Sweet Cravings in Dementia
A frequent change observed is sweet cravings in dementia. Individuals may develop a strong preference for sugary foods and drinks. This can be due to altered taste perception, comfort seeking, or simply the fact that sweet tastes remain appealing even when other flavours become dulled.
While it is important to encourage a balanced diet, moderate indulgence in sweet treats can bring joy and comfort. Substituting with healthier sweet options, such as fruit or yoghurt, can balance pleasure with nutrition.
Malnutrition Risk Dementia
The malnutrition risk in dementia is serious and should not be underestimated. Poor intake, dysphagia, behavioural changes and infections can all contribute to weight loss and nutrient deficiencies. Malnutrition weakens the immune system, reduces muscle strength and increases frailty, leading to a loss of independence and increased risk of hospitalisation.
Regular monitoring of weight, body condition, and food intake, along with nutritional support from professionals, can help to mitigate these risks.
Weight Loss in individuals living with dementia
Unintentional weight loss in people living with dementia is unfortunately common. It can result from a combination of factors discussed: reduced appetite, swallowing difficulties, food refusal and sensory changes. Weight loss can significantly affect energy levels, mood and resilience against illness.
Tailored interventions, such as offering frequent small meals, fortifying foods with calorie-dense ingredients and creating a relaxed, enjoyable dining environment, can help to slow or prevent weight loss.
