It’s highly likely that you know someone who has or is suffering with Alzheimer’s disease; it’s the most common type of dementia. Four million Americans have the disease; most are over 65. The loss of mental function has a direct bearing on the nutrition of the individual who has the disease.
In early stages of Alzheimer’s, a person may be able to feed himself but cannot eat in a setting that’s not familiar. In this situation, verbal cues are important for reassurance, so that proper nutrition is maintained.
As the disease progresses, however, the issues become more serious. Loved ones may forget how to perform certain functions relevant to eating, such as how to hold silverware, how to chew, when to swallow – all of which can mandate the need for mealtime coaching. In its final stages, Alzheimer’s robs our family members of the ability to swallow, and with less consumption of food, there can be, of course, a serious lack of nutrients for the body.
Nutritionists don’t have a set plan as we follow individuals with Alzheimer’s disease. Certain things can be more helpful, such as incorporating finger foods, to prolong independent eating. Therapeutic diets relevant to other chronic diseases are usually considered, because dietary intake is key: weight loss and low body weight are predictors of morbidity.
Offering his or her favorite foods and a variety of textures and flavors decreases the likelihood of “food fatigue.” At all times, and through all dietary challenges, the family member’s dignity must also be considered. Without dignity, the will suffers, and willpower is key to survival.
Victims of Alzheimer’s also build intolerance to change; new routines are hard on them, as are new environments. If your loved one has been transferred to a hospital or assisted living facility, then is when they will especially be prone to higher frustration levels over diminishing ability to perform simple tasks. A formerly simple act, such as opening a container or carton, can create rage in a new setting, so mealtimes are particularly treacherous during and after a transition.
In this situation, refusal to eat can actually be stemming from frustration over packaging or mechanics, without it being verbalized that way. Unfortunately, 75 percent of those with Alzheimer’s are admitted to resident care facilities within five years of diagnosis, so the gauntlet of a new environment is hard to avoid.
There are a couple of nutrition-related myths surrounding Alzheimer’s. One has been hanging on since the 1960s, when it was suspected that drinking from aluminum cans could lead to the disease. While experts have failed to find any evidence that this is true, the resulting “fear of aluminum” spread, and people have wondered about the safety of aluminum pots and pans, antacids and even antiperspirants.
Again, no evidence has been presented which justifies these fears, although as a registered dietitian and nutritionist I would prefer you drink nearly anything other than sodas, which are nutritionally devoid and can have high sugar levels.
The thought of diet sodas leads me to the second Alzheimer’s myth: that Aspartame causes memory loss. While all sorts of health concerns have come up about the artificial sweetener found in Equal and NutraSweet, the FDA’s findings – based on experiments by 100 clinical studies – find no evidence of an Alzheimer’s connection.
The subject of sugars and sweeteners is one I’ll save for another day.