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Dementia is a term that describes a loss of cognitive abilities, which can include thinking, memory, speech, reasoning, and other processes. Dementia patients may also show signs of appetite loss, and a diminished desire to eat as the result of cognitive impairment or other underlying factors, such as pain or fatigue, and these may become more prominent in the late stages of dementia.

In a 2015 study from Trusted Source, researchers compared various aspects of appetite and difficulties with eating between different types and stages of dementia. Eating difficulties can include difficulty swallowing and chewing as well as choking on food, and a decrease in appetite was found with all forms of dementia.

 

A person with dementia, such as Alzheimer’s disease, may lose his/her appetite for several reasons because eating and drinking require the use of motor areas in the brain, which coordinate muscles in the neck and throat. Many forms of dementias can affect a person’s control of their chewing and swallowing, and when this occurs a caregiver may notice some of the following signs: coughing or choking on food as a person eats, grimacing or refusing to swallow, making exaggerated tongue movements, throat clearing, or spitting food out. 

 

Other potential causes of appetite loss may include:

 

Fatigue: Fatigue, or extreme tiredness can cause a person with dementia to experience eating difficulties due to a lack of energy. This could lead to coordination and concentration issues and may lead to them giving up on eating halfway through a meal.

 

Constipation: About 25% of people with dementia experience constipation. This could lead to discomfort in the abdomen, resulting in their not wanting to eat more and avoiding meals in general. 

 

Depression: Depression is estimated to affect about 40% of people living with Alzheimer’s disease and can cause a person to lose interest in eating.

 

Mouth or Teeth Discomfort: In some cases, problems with a person’s gums, teeth and other complications in the mouth may make eating painful or uncomfortable.

 

Physical Activity: A lack of physical activity in people with dementia may lead to a decrease in appetite.

 

Communications Issues: If a person with dementia has trouble communicating, their refusal of food may be an attempt at communication. They may be trying to tell their caregiver that they do not like the food or are in pain when eating.

 

Sensory Changes: A loss or diminished sense of taste or smell may also be another factor, as these changes are common in dementia patients due to the degeneration of neurons in the brain.

 

There are ways to encourage appetite with dementia patients. They include providing pictures of various meals that the patient prefers and enjoys, and allowing him/her to point to the picture of the desired meal; providing smaller portions; serving finger foods that don’t require use of a fork; providing softer foods if swallowing is an issue; serving meals with stronger flavors; and not limiting dessert portions.

 

If a caregiver has concerns that a person with dementia is not eating enough, has obvious signs of malnourishment or is unable to eat, it is a good idea to contact the patient’s doctor. The physician can rule out underlying medical conditions such as dental pain, constipation, or depression and provide advice about filling nutritional needs or adding supplements or vitamins.

 

Caring for a patient with dementia is a long and challenging road. There is so much to know and learn about what the disease progression may look like, and while every patient and case has some similarities, every case is also somewhat unique. Support groups and geriatric care managers can help with answers to your questions and provide guidance and planning ideas needed for this often-long journey.

 

Ron Kauffman is a Consultant & Expert Speaker on Issues of Aging. You may contact him by phone at (828) 696-9799 or by email at: drron561@gmail.com