“Practical Approach to Nutritional Problems of Alzheimer’s Patients”

1. “Practical Approach to Nutritional Problems of Alzheimer’s Patients” Presented by: Ms. Dalia Kassas (Nutritionist)

2. Overview of Malnutrition • Malnutrition is the major concern of Alzheimer’s patients’ health problems. Regular, nutritious meals may become a challenge for people with dementia. • As a person's cognitive function declines, he or she may become overwhelmed with too many food choices, have a diminished sense of hunger and thirst, problems in eating or swallowing, forgetting to eat ,or problems in the ability of using utensils.

3. Causes of Poor Nutrition in Alzheimer’s Patients • Dry mouth • Poor appetite/ refusal of eating • Chewing problems • Swallowing problems

4. Dry Mouth • In case of a dry mouth: • ↑ patient’s water and fluids intake • Give fluids after each bite • Add broth and sauces to make food softer • Give them sour candies to increase saliva and to moisten the mouth

5. Poor Appetite/ Refusal of Food • Take a break and then return to eating • Serve several small meals instead of large ones • Don’t serve extremely hot food • Serve snacks between meals • Serve finger foods • Sometimes it helps to add some sugar to the food if they are healthy.

6. Chewing Problems • Offer to the patient pureed food • Offer them puddings like : mouhallabiyyeh … • Offer them soups, stews…

7. Swallowing Problems Incase of swallowing problems the patient needs to be fed by “tube feeding”: • NG tube: it’s used for a short period of time ( up to 3-4 weeks). The tube passes through the nose into the stomach. It can causes erosion of the nose, esophageal perforation, pulmonary aspiration.

8. Swallowing Problems • PEG tube: Percutaneous Endoscopic Gastrostomy, it’s done under local Anesthesia, it’s used for a long period of time. It’s more practical, less painful for the patient. • Dehydration is the most common complication of home tube feeding, so don’t forget to flush the tube with water at every feeding.

9. Nutrition concerns of Alzheimer’s patients • Common nutrition problems are poor protein status, anemias, dehydration, and weight loss. laboratory assessment of nutritional status should be checked. IF: • Total protein, albumin are low → poor protein status • Hemoglobin, hematocrit are low → nutritional anemia • Sodium, hemoglobin, hematocrit, and albumin are higher than usual → Dehydration

10. Nutritional tips for Alzheimer’s patients • Eat a balanced diet with a variety of foods • Limit food with high saturated fats and cholesterol. • Limit foods with high sodium • Drink enough water and fluids • Eat plenty of fruits and vegetables

11. Food Guide Pyramid in Adults vs. in Seniors

12. Conclusion Good nutrition is very important in Alzheimer's patients because malnutrition and dehydration may lead to: • Increased risk to infections • Delayed wound healing • Impaired respiratory function • Muscle weakness and depression