5 Small Changes To Eating Habits That Can Be Signs Of Dementia

Once your parents, grandparents or other older adults in your life reach a certain age, it’s natural to become hypervigilant about their changing health, wanting to catch any potential issues as soon as possible. (Not to mention, it makes you more self-aware about your own signs of aging.) Certainly, that includes being aware of the early signs of dementia.

Though there is no cure for dementia (which is an umbrella term describing multiple forms of cognitive impairment, with Alzheimer’s disease being the most common type), there are treatments that can slow progression so those who have it can have a better quality of life for longer. While memory problems are the hallmark symptom of dementia that many people focus on, it’s not the only early sign of dementia. Certain changes in eating habits and mealtime can also be signs of dementia.

“As a neurologist who has spent decades studying brain health and memory, one of the most common questions I get from families is this: ‘My mother has started eating strangely. Does that mean she has Alzheimer’s?’” Dr. Majid Fotuhi, a neurologist, adjunct professor at Johns Hopkins University’s Mind/Brain Institute, and author of “The Invincible Brain,” told HuffPost.

Fotuhi explained that the answer is more nuanced than a simple yes-or-no, but there are specific changes that often serve as a tell. Below are five changes in eating habits that can be signs of dementia, according to neurologists.

Futuhi emphasised that if someone you love develops new and unusual eating habits but their memory, judgment and daily functioning otherwise seem fine, that alone should not make you worry about Alzheimer’s. He explained that the changes could be an indication of something else, such as depression, anxiety, a side effect from medication or dental problems.

“This is exactly why a distinct and lasting change in eating behaviour deserves a proper medical evaluation rather than a guess,” Fotuhi said, adding that any changes in eating habits should be evaluated by a medical professional. With that in mind, below are five changes in eating habits to be on the lookout for.

“One of the earliest changes families might describe is that their loved one who cooked elaborate meals for decades starts making simpler dishes, then stops cooking altogether,” said Dr. Joel Salinas, a clinical associate professor of neurology at New York University Langone Health and chief medical officer at Isaac Health. Salinas pointed out that complex meals require planning and sequencing, skills that dementia affects. Dr. Adam Mednick, a neurologist and the author of “Normal Pressure Hydrocephalus: From Diagnosis to Treatment,” added that having trouble planning, shopping for and preparing meals can be early signs of dementia.

Just because someone stops cooking elaborate meals doesn’t mean they have dementia. But when accompanied by the other signs shared here, it’s something to be mindful of.

All three neurologists shared that losing interest in food is a common symptom of dementia, and there are several reasons why it happens. Fotuhi told HuffPost that changes in the brain can lead to loss of smell, which reduces the pleasure of eating, since much of what we experience as taste actually comes from smell. Salinas said this too, explaining, “Reduced smell strips much of the pleasure from food. Someone with dementia may describe meals as bland or flat.”

People with dementia are also at higher risk of experiencing depression, which Fotuhi said can blunt interest in activities, including mealtime. On top of that, all three experts point out that mealtime requires using utensils and maintaining conversations at the same time, which can feel stressful to someone with dementia. “A noisy, overstimulating, or unappealing setting makes this worse by making it harder to focus and engage,” Mednick added.

Since dementia impacts memory, all three neurologists say that it can lead to forgetting to eat or forgetting that they’ve already eaten. Part of what makes this even more likely is that dementia impacts the body’s hunger and fullness cues.

“Dementia makes it difficult to interpret the body’s internal signals for hunger and fullness and to connect them to external cues, such as the time of day or the sight of food,” Mednick said. He explained that damage to the brain regions that regulate appetite can blunt the drive to eat, while memory loss can cause someone to forget to eat, forget they just ate, or no longer recognise or communicate that they are hungry. “The result can go either way, leading to eating too little or, in some cases, overeating,” he said.

Even for someone without dementia, answering the whole “what’s for dinner?” question can be challenging. As the doctors explained earlier, mealtime requires planning, shopping and preparation. This, they shared, is why it’s common for people with dementia to eat the same meals or foods repeatedly.

“When thinking becomes effortful, every decision has a cost, and eating the same meal removes one decision from the day. Familiar foods are also predictable, which can feel safer when so much else feels uncertain,” Salinas said.

Fotuhi agreed, explaining that the same rigidity often shows up in other areas of life at the same time, such as insisting on the same daily schedule or the same clothing.

“A shift toward sweets is by far the most consistently reported change,” Mednick said, explaining that this change likely stems from damage to the brain’s reward and impulse-control circuits.

Fotuhi said that a newly developed sweet tooth is most common in those with frontotemporal dementia (FTD), which is a distinct group of brain disorders that damage the frontal and temporal lobes. “The frontal lobe normally helps us regulate impulses and food choices. When it is damaged, that regulation weakens, and a strong pull toward sweet and starchy foods often emerges, sometimes dramatically,” he explained.

If you are a caregiver or loved one to someone with dementia who is experiencing these changes in eating habits, confronting these new hurdles can feel overwhelming. But there are ways you can make mealtime less stressful and more enjoyable for everyone.

Instead of pressuring your loved one to eat, Alison Neov, a registered dietitian specialising in geriatric nutrition, told HuffPost that it’s more effective to focus on creating a positive mealtime environment. You can do this by keeping meals on a consistent schedule and serving foods you know they like.

Neov said she finds it helpful to offer smaller meals and avoid overcrowding the plate with food. “A large meal can be overwhelming when your appetite is low,” she said. If using utensils is a struggle, Neov and Salinas both said that serving finger foods, like sliced chicken with a dipping sauce or a sandwich cut into fours, can be helpful.

If possible, Neov recommends eating meals together. “Sometimes a person with dementia may struggle with a familiar task like eating, and seeing someone else pick up a fork and start eating can remind them to do the same,” she said.

A set table indicates that it’s time to eat. To avoid confusion, Neov told HuffPost that it’s best to keep the table set only at mealtime, something she said is especially helpful if someone is eating too frequently. Between mealtimes, keep the table cleared to signal that it’s not time to eat.

When it is time to eat, Neov recommends eliminating other distractions, such as having the TV on.

As the neurologists explained earlier, one of the eating changes that often happens with dementia is a craving for sweet, carb-dense foods. “It’s also OK if your loved one is not eating perfectly. The emphasis at this time is on making sure that they are eating enough calories and maintaining their weight. If they are only willing to eat a few different foods, I would rather see them eating enough than worry about whether every food choice is perfectly nutritious,” Neov said.

Instead of taking away the foods they seem to be interested in Neov shared that it can be more effective to find ways to enhance them. “For example, you can make a delicious smoothie with nutrient-dense ingredients that tastes like a milkshake. My favourite combination is yogurt, frozen fruit, banana, nut butter, and a splash of milk or water,” she said.

Neov shared that pairing not-so-healthy foods with healthier options (like fruit, vegetables, and nuts) is another way to add nutritional value to snacks that are nutritionally lacking.

Navigating changes in eating habits can be challenging, so don’t be afraid to reach out for help, either to your loved one’s healthcare provider or a registered dietitian specialising in geriatrics. “They can provide you with strategies to help keep mealtimes stress-free and also as nourishing as possible,” Neov said.

Changes in eating habits don’t mean that someone definitely has dementia, but they do deserve a medical evaluation. Before jumping to conclusions, the first step is making an appointment with a healthcare provider. That way, you’ll truly know how you can offer your support.