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Diet and Dementia:
What People with Dementia Need to Know
As we age, our dietary requirements change, and this is especially true for those living with dementia. It is important to ensure that our loved ones with dementia are receiving the necessary nutrients to maintain their physical and cognitive health. In this article, we will discuss the diet and dementia recommendations that may boost brain health and manage challenging dementia behaviours.
Diet and Dementia: How to Keep the Brain Healthy
One of the most important things to keep in mind when it comes to the diet of someone living with dementia is to maintain a well-balanced diet. A well-balanced diet consists of a variety of fruits, vegetables, whole grains, lean protein, and healthy fats. This will ensure that the individual is receiving all the necessary nutrients for their overall health. The following information in this section applies to people with dementia who do not have malnutrition or loss of appetite. iKare also has a blog post on healthy eating for elderly, check it out here.
If you are experiencing loss of appetite or weight loss, it may not be advised to restrict things like sugar or sodium. Speak to your dietitian to check what will work for you.
Eat Healthy Fats
Reduce the intake of foods that are high in saturated fat and cholesterol, as not all types of fat are beneficial for health. It is advisable to avoid unhealthy fats like butter, lard, solid shortening, and fatty meats, which are detrimental to heart health, and instead choose healthier options like olive, peanut or soybean oil, avocados or nuts.
Reduce refined carbohydrates and sugar
Lower your consumption of refined sugars, which are commonly found in processed foods, as they provide calories without essential nutrients such as vitamins, minerals, and fiber. It is better to satisfy your cravings for sweetness with alternatives like fruit or baked goods sweetened with applesauce or natural low-calorie sweeteners like monkfruit. However, it’s worth noting that in the advanced stages of Alzheimer’s, adding sugar to food might encourage eating if appetite loss is a concern.
Cut down on salt
Reduce the intake of high-sodium foods and use less salt or salty seasonings like soy sauce, stock powder, oyster sauce or preserved foods, as excessive sodium intake affects blood pressure, which is a common problem in Singapore. One study found that excessive dietary salt impairs cognitive function and increases cognitive impairment risk in older adults [1]. Consider using spices or herbs to enhance the flavor of your meals instead of salt or salty seasonings.
Specific Brain-Boosting Nutrients
In addition to a well-balanced diet, there are specific nutrients that can have a positive impact on the cognitive health of individuals living with dementia. Omega-3 fatty acids, found in foods such as fish and nuts, have been shown to reduce the risk of cognitive decline and dementia [2]. B vitamins, such as folate and vitamin B12, can also improve cognitive function [3]. These nutrients can be obtained through a well-balanced diet, but in some cases, supplementation may be necessary.
Stay Hydrated
It is important to ensure that the individual is staying hydrated. Older adults are at a higher risk of dehydration, and dehydration can exacerbate symptoms of dementia, such as confusion and disorientation. Encouraging the individual to drink fluids throughout the day, such as water and low-sugar juices, can help prevent dehydration.
Diet and Dementia:
Challenging Eating Issues
Another important aspect of diet and dementia is to ensure that the food is easily chewed and swallowed. Chewing and swallowing can become difficult for individuals with dementia, and this can increase the risk of choking and aspiration. Soft foods, such as mashed potatoes and cooked vegetables, can be easier to chew and swallow. It is also important to cut food into small pieces and avoid foods that are hard, sticky, or tough.
Mealtime can be a challenge for those living with dementia, as they may have difficulty with decision-making and may become easily overwhelmed. It is important to create a calm and comfortable environment during mealtime. This can be achieved by reducing noise and distractions, and using simple and familiar dishes. Family members and caregivers can also provide gentle encouragement and support during mealtime.
In some cases, individuals living with dementia may experience a loss of appetite or difficulty with eating. This can lead to weight loss and malnutrition, which can further exacerbate the symptoms of dementia. There are several strategies that can be used to encourage eating and prevent weight loss. Offering small, frequent meals throughout the day can be more manageable for individuals with dementia, and can help prevent feelings of fullness and discomfort. Finger foods, such as crackers and fruit, can be easier to eat than meals that require utensils. It is also important to offer a variety of foods to ensure that the individual is receiving all the necessary nutrients.
There are also some specific strategies that might help with diet and dementia.
Make Mealtimes More Enjoyable Again, Less of a Struggle
Mealtimes can be challenging during the middle stages of dementia, but with a few tips, you can make them calm and comfortable.
Here are some ideas on diet and dementia that can help you and your loved one:
- Distinguish food from the plate and plate from the table. Changes in visual and spatial abilities may make it tough for someone with dementia to distinguish food from the plate or the plate from the table. Using contrasting colors between plates and tablecloths can help. Try using white plates or bowls with a contrasting color placemat. Avoid patterned dishes, tablecloths, and place mats.
Keep the table setting simple. You can also consider using plastic tablecloths, napkins or aprons to make clean-up easier. Provide only the utensils needed for the meal to avoid confusion.
Limit distractions. Try to serve meals in a quiet environment, away from the television and other distractions. This will help your loved one focus on their food and enjoy the meal.
Be flexible with food preferences. It is possible the person may suddenly develop certain food preferences or reject foods they may have liked in the past; understand this is normal and cater to their new preferences accordingly.
Check the food temperature. A person living with dementia might not be able to tell if something is too hot to eat or drink. Always test the temperature of foods and beverages before serving.
Don’t rush it: Allow plenty of time to eat. Keep in mind that it can take an hour or more for the person to finish their meal.
Offer one food item at a time. The person may be unable to decide among the foods on their plate. Serve only one or two items at a time. For example, serve the protein dish first, followed by the vegetables, then some rice/porridge.
Keep in mind the person may not remember when or if they ate. If the person continues to ask about eating breakfast, consider serving several breakfasts — juice, followed by toast, followed by cereal.
Eat together. Give the person the opportunity to eat with others. Keeping mealtimes social can encourage the person to eat.
Maintaining Independence is Important in Diet and Dementia
Making mealtimes easier for someone with dementia can be a challenge. During the middle stage of the disease, it’s important to encourage independence as much as possible. Why not just spoonfeed them instead? Because many studies have emphasised the need for interventions which maximise independence and autonomy at mealtimes to improve quality of life, reduce strain on caregivers, and provide dignity and mental wellbeing for people with dementia [4].
But don’t worry – we’ve got some tips that can help!
1. First, try to make the most of the person’s abilities. Adapting serving dishes and utensils can make a big difference. For example, a bowl may be easier to use than a plate, and a spoon with a large handle can be easier to handle than a fork. You might even consider letting the person use their hands if it’s easier.
2. Finger foods can also be a great option. Bite-sized foods like homemade chicken nuggets, fish cakes, satay tempeh chunks, and orange segments are easy to pick up and eat. You could even make a meal in the form of a sandwich to make it easier for the person to serve themselves.
3. If the person needs help eating, try hand-over-hand feeding. Show them how to eat by putting a utensil in their hand, placing your hand around theirs, and lifting both of your hands to their mouth for a bite.
4. Don’t worry about neatness – let the person feed themselves as much as possible. Use non-skid surfaces like a cloth or towel under bowls and plates, and consider using cups and mugs with lids to prevent spilling. Fill glasses halfway and use bendable straws.
Remember, it’s important to encourage independence and make mealtimes as easy and stress-free as possible for both you and your loved one.
Conclusion
We hope these tips help make mealtimes a more enjoyable experience for you and your loved one with dementia. It is important to keep in mind that every individual is different, and what works for one individual may not work for another. It is important to work with a healthcare provider or registered dietitian to develop a personalised dietary plan for someone living with dementia.
A well-balanced diet is important for maintaining the physical and cognitive health of individuals living with dementia. By working with a qualified dietitian like the one at iKare, individuals with dementia can optimise their diet and maintain their overall health and wellbeing. Speak to our team to get more individualised advice best suited for you.
References:
[1] Weike Liu, Shasha Xing, Fang Wei, Hua Zhang, Yue-Chun Li, Zhendong Liu. Excessive Dietary Salt Intake Exacerbates Cognitive Impairment Progression and Increases Dementia Risk in Older Adults. JAMDA. January 2023. Volume 24, Issue 1. P 125-129,
[2] Dangour AD, Andreeva VA, Sydenham E, et al. Omega 3 fatty acids and cognitive health in older people. Br J Nutr. 2012 Jun;107 Suppl 2:S152-8.
[3] Wang HX, Wahlin A, Basun H, Fastborn J, Winblad B, Fratiglioni L. Vitamin B12 and folate in relation to the development of Alzheimer’s disease. Neurology. 2001; 56:1188-1194.
[4] James Faraday, Clare Abley, Joanne M Patterson, et al. How do we provide good mealtime care for people with dementia living in care homes? A systematic review of carer–resident interactions. Journal of Applied Gerontology. Apr 2021. 35(1), 10-26. doi: 10.1177/0733464814556998
General Helpline:
for Dementia Support: For more information, you can call. [8. healthhub.sg]
- HPB Dementia Infoline: 1800 223 1123. For general inquiries on dementia
- Institute of Mental Health (IMH): 6389 2000. For general inquiries on clinical services and psychiatric care.
- Samaritans of Singapore (SOS): 1800 221 4444. Emotional support for anyone in.
- Dementia Singapore: 6377 0700. For caregiver support and dementia care services.
- Singapore Association of Mental Health (SAMH): 1800 283 7019. For general inquiries on rehabilitative and outreach services
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