Have you heard of the term Cognitive Impairment?
How often do you think about nutrition and cognitive function?
Neurodegenerative disorders are characterised by the gradual loss of specific groups of messenger nerves over time. Dementia steadily targets and destroys particular areas of the brain. This slow and progressive decline makes these conditions tough to manage, as they gradually affect memory, movement, and other critical functions.
Let’s know more about ‘Dementia’
According to WHO, dementia is a complex condition caused by various diseases that slowly damage the brain and destroy nerve cells over time. This leads to a decline in cognitive abilities—such as memory, reasoning, and thinking—that goes beyond the natural process of aging. A person with dementia often experiences changes in mood, behaviour, motivation, and emotional control. Dementia is a broad medical term affecting many aspects of life including physical, psychological, social and economical but it is not a specific disease on its own, it is an umbrella term that describes the decline in one’s mental ability. It surely affects the individual living with the condition but at the same time, it also affects the caregiver and the family. Due to the lack of awareness and understanding about dementia barriers are created to give proper care and support to the families making them feel isolated. The estimated number of individuals around the world with dementia in 2006 was 26.6 million which is estimated to increase to 106.8 million by 2050.
When doctors suspect dementia, their goal is to figure out what is causing it. Alzheimer’s disease is the most common cause, but vascular dementia is often next on the list, caused by problems with blood flow to the brain. In some places, Lewy body dementia comes in second. Sometimes, people have a mix of Alzheimer’s and vascular dementia, which is also fairly common.
The prevalence of dementia in Australia as estimated by the Australian Institute of Health and Welfare (AIHW) states that the number of people living with dementia in Australia is expected to more than double in the coming decades. In 2023, over 411,000 Australians had dementia, and by 2058, that number is predicted to soar to around 849,300.
The graft showing the number of people being affected with dementia, would be on an increasing trend. As it suggests, the total number of people with dementia is estimated to rise above 800,000, out of which more than 400,000 would be females and 200,000 would be males.
According to the 2020 Lancet Commissions report on dementia prevention, intervention and care, there are a total of 12 modifiable risk factors that can reduce the incidence or onset of dementia by 40 %, these risk factors include lack of primary and secondary education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, infrequent social contact, excessive alcohol consumption, head injury, and air pollution.
Image credits: 2020 Lancet Commission Report: Dementia Prevention
Nutrition for better cognition
Now let us dive into the world of nutrition and uncover what our food can help manage the symptoms and complications of this broad-spectrum disease. In the previous blog (link to be attached) we read about the brain diet– the right nutrition your brain requires and the best ways to maximise their usage. The food we eat fuels the brain and prevents the onset of dementia, but however, the right nutrition and mindful eating will also play a role in the care of dementia and slowing its progression.
Nourishing neurons
The brain needs a constant supply of nutrients to function properly and protect itself from damage, just like we need constant motivation to function daily. Because the brain is so active, it quickly uses up the nutrients that need to be replaced regularly. Imagine you are hungry and your food gets delivered to you on time, similarly when the brain requires its nutrients they are delivered quickly via the blood through the blood-brain barrier. Now just like we cannot make certain recipes and we rely for them on our favorite restaurants or food chains, the body also cannot make certain nutrients the brain requires and hence have to get them from the food we eat. So, eating a balanced diet is essential to keeping the brain healthy and protecting it from oxidative damage, stress and injury!
Mediterranean Diet
Various diets have been analysed and studied over the years to understand their effects on cognitive function and the onset of dementia. A study from Australia found that people who follow a Western diet tend to experience a faster decline in the cognitive abilities. On the other hand, the Mediterranean Diet, which has been widely studied, shows clear protective benefits against cognitive decline and dementia. One standout study, the PREDIMED trial in Spain, found that participants on a Mediterranean diet (with extra-virgin olive oil or nuts) had better cognitive function when compared to those on a low-fat diet.
DASH Diet
Another diet gaining recognition for its brain-boosting benefits is the DASH diet (Dietary Approaches to Stop Hypertension), originally designed to lower blood pressure. Research has shown that this diet not only improves cognitive function but also helps reduce the risk of dementia. Together, these findings highlight the powerful role of nutrition in supporting brain health and preventing cognitive decline.
Mediterranean Diet Focus: Rich in plant-based foods, healthy fats (olive oil), fish, moderate wine, and limited red meat.
DASH Diet Focus: Low in sodium, rich in fruits, vegetables, whole grains, and lean proteins to support heart health and lower blood pressure.
Foods to include | Mediterranean Diet | DASH Diet |
Whole Grains | Brown rice, whole wheat, oats, quinoa, barley | |
Legumes | Lentils, chickpeas, black beans, peas | |
Dairy | Low fat milk, yogurt, cottage cheese | |
Fruits | Berries, oranges, apples, grapes, figs, tomatoes, bananas, peaches | |
Protein | Chicken, turkey, eggs | Skinless poultry, fish, beans, legumes, egg |
Vegetables | Leafy greens, tomatoes, cucumbers, broccoli, peppers | Carrots, spinach, kale, broccoli, squash |
Healthy fats | Extra-virgin olive oil, avocado, nuts (almonds, walnuts), fish (salmon, sardines, mackerel) | Unsalted nuts, seeds, healthy oils (olive oil, canola oil) |
Nordic Diet
Additionally, the ‘Nordic diet’ is gaining attention for its neuro-protective benefits. It is similar to the Mediterranean diet but has its own specificities. The Nordic diet and the Mediterranean diet are both healthy, plant-forward eating patterns, but they reflect the cuisines of different regions. The Nordic diet, rooted in the Nordic countries, focuses on cold-weather foods like berries, root vegetables, rye, and fatty fish such as salmon and herring, with rapeseed oil as the primary fat source. It emphasises sustainability, seasonal eating, and local ingredients. In contrast, the Mediterranean diet, inspired by Southern European cuisines, includes warm-climate foods such as tomatoes, olive oil, citrus fruits, and a broader variety of grains like wheat, bulgur, and farro. It also incorporates moderate amounts of red wine and prioritises olive oil as a key fat source.
While both diets reduce processed foods and promote whole grains, vegetables, and seafood, the Nordic diet leans toward hearty, fermented, and roasted foods, while the Mediterranean diet highlights vibrant, fresh, and grilled dishes.
Move for better cognition
We always hear people saying exercise is important for a healthy and stress-free life, while exercise might seem like too much of a hard work but as the saying goes ‘consistency is the key’ hence being consistent with the physical activity will help improve cognition. Moreover, research suggests that exercise is a non-pharmaceutical intervention, especially when done in combination that includes endurance, strength and balance training leading to improvement in physical functioning in patients with dementia.
Setting SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) and small goals can significantly benefit patients with dementia. SMART goals help keep dementia patients mentally engaged, slowing cognitive decline by stimulating memory and focus. Achievable goals boost motivation and confidence, countering frustration. They also provide routine and structure, reducing anxiety. Physical goals promote movement, improving health and mood. Overall, SMART goals maintain independence and dignity, lessening caregiver burden.
Mindful mealtimes
Caregivers play a crucial role in ensuring dementia patients receive proper nutrition, especially as feeding challenges arise. Their dedication and adaptability help maintain patients’ health. The following guidelines provide strategies to improve the feeding experience for dementia patients.
- Create a Calm Mealtime Environment: Minimize distractions, maintain a quiet atmosphere, and establish consistent routines to reduce confusion.
- Offer Smaller, Frequent Meals: Serve smaller portions and provide nutritious snacks to encourage steady intake without overwhelming the patient.
- Provide Familiar Foods: Serve foods the patient enjoys and recognizes to promote appetite and reduce resistance.
- Assist with Eating: Offer physical assistance and verbal cues when needed, while encouraging independence.
- Ensure Hydration and Adjust Food Texture: Encourage regular fluid intake and modify food consistency to address swallowing difficulties and prevent choking.
Key Takeaways:
- Balanced Nutrition Slows Dementia Progression: Eating a balanced diet rich in nutrients is crucial to support brain health, potentially slowing the progression of dementia and protecting cognitive function.
- Mediterranean and DASH Diets Promote Cognitive Health: The Mediterranean and DASH diets, both rich in whole grains, fruits, vegetables, healthy fats, and lean proteins, are shown to reduce the risk of dementia and improve cognitive abilities.
- Feeding Strategies for Dementia Care: Creating a calm, structured mealtime, offering smaller and more frequent meals, and using familiar foods help dementia patients maintain proper nutrition.
- Hydration and Food Consistency Are Key: Ensuring adequate hydration and modifying food textures (e.g., soft or pureed) can assist with swallowing difficulties that dementia patients may face.
- Monitor Nutrition Closely: Caregivers should track signs of malnutrition, weight loss, or changes in appetite, and consult with healthcare professionals to meet the specific nutritional needs of dementia patients.
Disclaimer: The information provided in this blog is sourced from research articles and reputable websites. However, as each individual’s body and health needs are unique, it is essential to consult with your doctor, dietitian, or healthcare provider for personalised advice and plans tailored specifically to your condition.
Acknowledgement: I would like to extend my heartfelt gratitude to our CEO, Purva Gulyani – Accredited Practising Dietitian, for providing me with the opportunity to contribute to this blog. Your valuable feedback, along with your time spent proofreading and editing, has greatly enhanced the quality of this work. Your guidance and support are truly appreciated.
References:
- https://www.asha.org/practice-portal/clinical-topics/dementia/#:~:text=In%20general%2C%20individuals%20with%20dementia,more%20of%20the%20following%20domains.
- https://www.who.int/news-room/fact-sheets/detail/dementia#:~:text=Dementia%20is%20a%20syndrome%20that,solving%20problems%20or%20making%20decisions
- https://www.alzheimers.gov/alzheimers-dementias/lewy-body-dementia
- https://www.alzheimers.gov/alzheimers-dementias/alzheimers-disease
- https://www.aihw.gov.au/reports/dementia/dementia-in-aus/contents/population-health-impacts-of-dementia/prevalence-of-dementia#NumberofAustralias
- https://www.health.qld.gov.au/__data/assets/pdf_file/0032/946049/cardiac-meddiet.pdf
- https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456#:~:text=The%20DASH%20diet%20focuses%20on,and%20full%2Dfat%20dairy%20products.
- https://www.nia.nih.gov/health/alzheimers-caregiving/tips-caregivers-helping-people-alzheimers-disease-eat-well#:~:text=Over%20time%2C%20people%20with%20Alzheimer’s,stages%20of%20Alzheimer’s%2C%20appetite%20declines.
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