Dietary intervention in older adults with early-stage Alzheimer Dementia: Early lessons learned

Abstract

In older adults, an adequate diet depends on their ability to procure and prepare food and eat independently or the availability of dietary assistance when needed. Inadequate food intake or increased nutritional requirements lead to poor nutritional status, which is considered a key determinant of morbidity, increased risk of infection, and mortality in elderly individuals. Weight loss among seniors also heralds increased morbidity and mortality. Dietary behaviour disorders affecting food consumption, nutrition status and maintenance of body weight are common in older adults, and have a substantial impact on nutritional status and quality of life among older adults with Alzheimer Dementia (AD). The Nutrition Intervention Study (NIS) is ongoing. It employs a quasi-experimental pre-post intervention design in physically-well, community-dwelling early stage AD patients aged 70 y or older. To date, 34 intervention group patients and 25 control group participants have been recruited with their primary caregivers (CG) from 6 hospital-based memory and geriatric clinics in Montreal. The NIS uses clinical dietetics principles to develop and offer tailored dietary strategies to patients and their CG. This paper reports on the application of dietary intervention strategies in two intervention group participants; one was deemed successful while the other was considered unsuccessful. The report documents challenges encountered in assessing and counselling this clientele, and seeks to explain the outcome of intervention in these patients.

Strategies to support engagement and continuity of activity during mealtimes for families living with dementia; a qualitative study

“…Most intervention research to date has emphasized eating behaviours and improving food intake and nutritional status of persons with dementia [14, 34, 35, 46]. When discussing mealtime activities and behaviours, a negative discourse is often used, focusing on decline [28] and using terms such as ‘aversive eating behaviors’ [29].…”

“…Work to date suggests challenges in coping with the many changes experienced in mealtime activities leads to caregiver stress [9, 28, 29] and this stress predicts weight loss in the person with dementia [33]. Education delivered in family caregiver support programs tends to be focused on how to change diet, maintain body weight, and access external resources [14, 34, 35]. Based on the knowledge that mealtimes are more than ‘food on the plate’, an examination of strategies to support the mealtime process developed and used by families living with dementia is needed to provide a more comprehensive basis for these education programs.…”

Prevention of Dementia: Focus on Lifestyle

“…In this study, nutrient intakes from diet and supplements were higher in control subjects, with significant differences in energy, the macronutrients calcium, iron, zinc, vitamin K, vitamin A, and dietary fiber as well as n -3 and n -6 fatty acids [63]. The authors suggested that suboptimal diet is early in the onset of the disease and that AD patients would benefit from systematic dietary assessment and intervention to prevent further deterioration in food consumption and increased nutritional risk.…”

Pen-2 overexpression induces Aβ-42 production, memory defect, motor activity enhancement and feeding behavior dysfunction in NSE/Pen-2 transgenic mice

“…Recently, the alteration of the feeding behavior in an AD model animal was reported for the first time (31,32). APP23 Tg mice overexpressing human APP cDNA encoding the Swedish double mutation (K670N/M671L) under the control of the neuron-specific murine Thy-1.2 promoter showed the pathological features, learning and memory deficits analogous to AD patients (33).…”