Why Alzheimer’s disease puts elders at risk for weight loss 

According to the Alzheimer’s Association, as many as 1 in 9 people in the United States over the age of 65 has Alzheimer’s disease. Many of these elders live in long-term care facilities to make up approximately 40% of the total residents in a facility. Although Alzheimer’s presents a number of health challenges, an often overlooked consequence is the heightened risk of weight loss among those affected by this condition.  

Overview of Alzheimer’s disease

Alzheimer’s disease is a progressive neurological disorder characterized by a decline in memory and cognitive function, negatively affecting one’s ability to perform daily tasks such as dressing, bathing, walking, talking, and eating. There is currently no cure for Alzheimer’s, so treatment focuses primarily on managing symptoms to improve one’s quality of life.  

The impact of cognitive decline on eating habits

The impact that Alzheimer’s has on one’s cognitive function is considered the culprit of some of the most devastating effects in a patient’s complex and challenging journey. Change in eating habits is one area that is significantly impacted and puts elders at risk for weight loss. Let’s take a closer look at the five ways Alzheimer’s influences a person’s eating behaviors: 

1. Loss of appetite. Changes in the brain related to cognitive decline can result in a decreased appetite. This occurs because there is a reduced sense of hunger, a person forgets to eat, or has a decreased interest in eating altogether. 
2. Change in food preferences. When cognition declines, this can impact a person’s ability to recognize foods that they used to enjoy or cause perceived changes in the taste and smell of foods making them less appealing or unrecognizable. Forgetfulness can also lead to missed meals or irregular eating patterns compared to their usual eating habits.
3. Difficulty or inability to prepare meals. Cognitive decline can cause increased difficulty when it comes to planning and executing tasks such as meal preparation, following recipes, and using cooking appliances. 
4. Difficulty in chewing/swallowing. As Alzheimer’s progresses, dysphagia becomes a potential concern that often requires food and liquid textures to be modified. With dysphagia, it can be hard and laborious for a person to eat and often, an aversion to food develops due to the change. In addition, texture-modified foods may be unappealing.
5. Resistance to assistance. A person may begin to need assistance for several reasons including a decline in coordination and motor skills required for eating. It is not uncommon for one to be resistant to help as cognitive decline often leads to decreased awareness of one’s limitation or need for help. 

Nutritional strategies to promote adequate nutritional intake

It’s important to encourage adequate nutritional intake in people with Alzheimer’s disease due to the many barriers they face in consuming enough to meet their nutritional needs. The following are some strategies that can be used to promote nutritional intake and ultimately prevent weight loss: 

• Offer easy-to-eat foods or finger foods. 
• Provide small, frequent meals for a steady stream of nutrients and opportunities to eat and drink. 
• Serve nutrient-dense foods to maximize nutritional benefits in smaller portions.
• Use oral nutrition supplementation as needed to provide additional calories, protein, and hydration.
• Establish regular mealtime routines to provide structure and predictability with eating. 
• Modify textures of food and fluids as needed to prevent choking and help make eating and drinking easier.
• Educate caregivers on feeding techniques that are conducive to a positive eating environment such as sitting with the patient on their level, engaging in conversation with the patient, eating in a well-lit and attractive area, and playing background music to enhance the overall dining experience. 

Conclusion 

As cognition declines and behavioral changes occur due to the progression of Alzheimer’s disease, it is important to be aware that nutritional status is impacted, and weight loss becomes a risk factor that should be considered. Recognizing the early signs of decreased nutritional intake and implementing nutritional strategies become crucial. Regular monitoring of nutritional intake, tolerance to diet, and weight status can all contribute to the prevention of weight loss and can improve one’s quality of life with Alzheimer’s disease.

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References: 

What is Alzheimer’s Disease? Available at https://www.alz.org/alzheimers-dementia/what-is-alzheimers Accessed on 12/2/23.