Alzheimer’s disease (AD) is a chronic degenerative disorder of unknown origin that causes gradual loss of abilities in memory, thinking, reasoning, orientation and concentration, with accompanying symptoms of loss of independence, disordered eating behaviour and weight loss.
It is not the result of normal ageing, but it does occur more frequently in people 65 years of age or older. The deterioration in the condition is progressive with the individual having an average life expectancy of 8 to10 years from the time of diagnosis.
Individuals with the disease have impaired attention span, reasoning and judgment and often fail to recognise feelings of hunger, thirst and satiety. In early stages, they may have difficulty preparing meals and may even forget to eat. As the attention span decreases the person may become depressed leading to loss of appetite and eventually eating problems. As the disease progresses the individual loses the ability to recognise thirst or hunger and may not eat adequately or drink enough of water and may become malnourished and dehydrated.
Alzheimer’s disease causes the appetite control systems in the brain to malfunction, resulting in extreme eating behaviours like overeating or not eating at all. It also becomes difficult to predict an individual’s response to food. They may develop an aversion to foods that used to be their favourites.
Generally, a person with the disease shows a marked preference for sweet foods and regular and excessive consumption of such foods can result in restless behaviour followed by feeling of tiredness and depression. Similarly junk foods tend to make the person more restless and disoriented and reduce cravings for more nutritious food. These can lead to weight gain especially when physical activity is restricted.
The process of eating especially using a spoon and fork or knife may be affected and become frustrating as the individual’s visual perception by the brain may be affected. As a result, the individual may lose interest in eating altogether and become dependent on others for feeding.
As the condition of the person deteriorates, more serious dietary problems arise. They are easily distracted by the slightest noise, conversation and odours while eating. Once distracted, it is very difficult to direct their attention back to the meal; hence they may eat less or not at all.
Many individuals wander about or are extremely restless which increases their need for calories; others may develop behavioural, physical or neurological problems such as confusion, anxiety, loss of muscular control in the mouth, difficulties with chewing and swallowing, agitation and dental problems that interfere with food intake.
A person with Alzheimer’s disease may also have impaired reasoning and may consume inedible items, spoiled foods or hazardous fluids and need to be closely supervised, particularly at mealtime.
Inadequate food intake over a period of time leads to weight loss, malnutrition and increased inability to perform the daily activities. The maintenance of adequate hydration must be ensured. Some individuals, with Alzheimer’s disease may also be constipated. Deficiencies involving several vitamins and minerals may also arise, unless supplements are provided.
As an individual suffering from Alzheimer’s disease cannot sense or identify thirst, hunger or fullness, it becomes a difficult task for caregivers to provide them with nutritious meals and snacks.
To be continued. . .
(The writer is a Consultant Nutritionist with 18 years of experience, practising at Panaji and can be contacted on firstname.lastname@example.org)