Eating Behavior in Aging and Dementia: The Need for a Comprehensive Assessment

Abstract

Eating behavior can change during aging due to physiological, psychological, and social changes. Modifications can occur at different levels: (1) in food choice, (2) in eating habits, and (3) in dietary intake. A good dietary behavior, like the Mediterranean dietary pattern, can be a protective factor for some aging related pathologies, such as dementia, while a worse eating behavior can lead to pathological conditions such as malnutrition. Changes in eating behavior can also be linked to the onset of dementia: for some types of dementia, such as frontotemporal dementia, dietary changes are one of the key clinical diagnostic feature, for others, like Alzheimer's disease, weight loss is a clinical reported feature. For these reasons, it is important to be able to assess eating behavior in a proper way, considering that there are normal age-related changes. An adequate assessment of dietary behavior can help to plan preventive intervention strategies for heathy aging or can help to identify abnormal behaviors that underline aging related-diseases. In this review, we have analyzed normal age-related and dementia-related changes and the tools that can be used to assess eating behavior. Thus, we make recommendations to screening and monitoring eating behavior in aging and dementia, and to adopt these tools in clinical practice.

Nutrition and Congruent Care Improve Wellbeing of Residents With Dementia in Slovenian Care Homes

“…We adopted the three-component taxonomy of dietary behavior of Fostinelli et al (5), as it is designed to form a consensus in the levels of nutritional care needed for people with dementia. The three components (food choice, eating behavior and dietary intake) were thus used as the basis for our results, according to which the statements of the interviewees were grouped, and statistical analyses were performed.…”

“…During the onset of the disorder, impairments usually include difficulties in purchasing and preparing products, the preparation of simple dishes, forgetting to eat and drink, or eating multiple times a day. A decline in the sense of smell is also characteristic of the early stages of dementia (5). People with dementia may also experience increased appetite and rapid eating, and may repeatedly ask for food or exhibit compulsive eating (4).…”

“…The general guidelines for the nutritional care of people with dementia are attractive and inviting meals, a daily routine and encouragement during mealtimes, variety in the menu, and respect for choice. The timing of meals and a calm and comfortable dining environment, as well as the food quality and suitability, are all important factors to consider (5,8,9).…”

“…To more easily identify and evaluate the different areas of nutritional care that must be monitored and adjusted in everyday congruent care, Fostinelli et al (5) suggest a taxonomy of three components: food choice (food preference and preparation); eating behavior (outcomes related to consumption, eating habits, eating disorders); and dietary intake (what is consumed, overall intake, specific nutrients). The authors further provide the theoretical framework that the three factors depend on (or are related to), i.e.…”

Physical Activity and Nutritional Influence on Immune Function: An Important Strategy to Improve Immunity and Health Status

“…However, micronutrient deficiencies are more common in older people (Conzade et al, 2017). Lower food intake has been linked to less intake of calcium, iron, zinc, B vitamins, and vitamin E in older people, directly related to micronutrient deficiency (Fostinelli et al, 2020).…”