Malnutrition and Dementia

As we get older, we often lose interest in cooking or can find it difficult to cook tasty, interesting and healthy foods on a budget. Also, as we age we may have more dietary factors to consider as certain illnesses are more prevalent among older people.

Older people with poor nutrition are more susceptible to infections, take longer to recover from illness and those admitted to hospital respond less well to treatment, stay longer in hospital and have poorer outcomes than well nourished patients. For this reason it is essential that we remember the importance of good nutrition, especially in our later years.

Signs of Malnutrition

The National Institute for Health and Care Excellence (NICE) defines a person as being malnourished if they have:

A body mass index (BMI) of less than 18.5 kg/m2
Unintentional weight loss greater than 10% within the past 3–6 months
A BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the past 3–6 months

However, as a carergiver, there are other signs to look out for. These may include:

Jewellery slipping off or becoming looser
The person you care for needing to tighten their belt buckle an extra notch
Changes in mood
Frequent colds or infections
Loosing dentures, difficulty eating or other oral problems
A lack of food, or food that has gone uneaten in the cupboard or fridge
General disinterest in food and/or fluids
Tiredness or lethargy
Difficulty keeping warm
Dizziness

Tips To Prevent Malnutrition

If your loved one has nobody to frequently check for malnutrition, then it may be time to look at in-home care or other options
If they struggle to eat large meals, try to divide food up into smaller meals and snacks that they can eat throughout the day
Try a small snack between meals and a dessert after meals
If co-ordination has declined since a dementia diagnosis, finger foods can be a good choice as your loved one can usually pick up and nibble them more easily
Drinking plenty of fluids can help to prevent fatigue. Try to have drinks with and between meals but not before, to avoid feeling too full to eat. Choose milky drinks and remember that hot drinks will also help keep you warm
Avoid low fat/diet versions of food and drinks, e.g. low fat milk, low fat yoghurt, diet drinks etc
Choose meals you enjoy, are easy to prepare and eat, and are high in calories
Serve food up in bright colour-contrast crockery. Blue plates can help someone to see their food more easily because it will contrast with the food (unless of course they’re eating blue food, which is unlikely in most cases)
In the later stages of Dementia, chewing and swallowing may become a problem. Someone may have to help by pureeing foods and helping with eating
Some home care agencies also provide cooking services for the elderly

Tips To Treat Malnutrition

If malnutrition is suspected, the person may need to see a doctor and/or a dietitian, as a malnourished person with a poor appetite may require a diet that is somewhat different, for ex, they may initially need more high calorie and more sugary foods than a balanced diet would normally recommend so as to improve energy intake. Making an appointment with the doctor can also be useful in case the weight loss is being caused by an underlying health problem (rather than just simply not eating enough food).

If it’s established that they are underweight, the doctor/dietitian will probably prescribe an eating plan aimed at helping the person put weight on, which will include lots of high nutrient/high calorie foods. Typical foods could include full fat milk and cheese, buttery mashed potato, creamy soups, avocados, nuts and seeds (these can be chopped or milled if the person struggles with chewing).

Protein is very important, of which the main source is meat, but you can also serve up scrambled eggs or beans. Meat that doesn’t require too much chewing can be a good idea, so mince dishes such as shepherd’s pie, cottage pie or Bolognese may be more suitable. Another good option is fortified shakes which contain large amounts of calories to increase weight as well as a range of different vitamins and minerals.