Appetite and dementia

There are many reasons why a person with dementia may experience a change in their relationship with food. Some may lose interest in meals and seem to have reduced appetite, while others become anxious about not eating enough.

How can dementia affect a person's appetite?

Some people with dementia lose interest in food, while other people may eat too much or too often. They may have forgotten that they’ve recently eaten, or worry about when the next meal is coming.

Jump to overeating and dementia

Poor appetite and stopping eating

A person with dementia may lose interest in food. They may refuse to eat it or spit it out. The person may become angry or distressed, or behave in a challenging way during mealtimes. 

If someone isn’t eating enough, it can lead to weight loss and less muscle strength. They may also feel tired and weak. This can make them frailer and less able to recover from infections or viruses. 

If you’re concerned about someone who continues to refuse to eat, speak to a pharmacist or the GP

Why someone with dementia might stop eating

A person may lose interest in, or turn down, food and drink because of physical difficulties, such as problems with chewing and swallowing, or constipation. 

There are other reasons why a person may stop eating. Understanding the reason can help you find appropriate support and solutions.

  • Depression 

    Loss of appetite can be a sign of depression - a common in people with dementia. There are effective treatments for depression, including medication and other therapies. If you suspect that the person you are caring for has depression, talk to the GP

  • Communication barriers 

    The person may have problems communicating that they’re hungry, that they don’t like the food they have been given or that the food is too hot. They may be unsure what to do with the food. They may communicate their needs through their behaviour, 
    such as refusing to eat or holding food in their mouth.

    You could try giving them a choice of food, or use prompts and pictures so they can choose the food they would like. 

  • Pain 

    The person may be in pain or discomfort, which can make eating difficult. They may have problems with their dentures, sore gums or painful teeth. Going to the dentist for oral hygiene and regular mouth checks is important.

  • Tiredness and concentration 

    Tiredness can cause people with dementia to not eat or to give up partway through a meal. It can also lead to other difficulties, such as problems with concentration or with coordination. A person with dementia may have difficulties focusing on a meal all the way through. Try to support the person to eat when they are most alert.

  • Medication 

    Changes to medication or dosage can affect a person’s appetite. If you think this may be the case, speak to a pharmacist or the GP.

  • Physical activity 

    If the person is not very active during the day, they may not feel hungry. Encouraging them to be active will be good for their wellbeing and may increase their appetite. 

    Equally, if the person is very active or restless – for example, walking about or fidgeting – they may use extra calories and may be hungrier than usual or lose weight more quickly.

What can you do to help?

There are lots of ways to increase a person’s appetite and interest in food and drink. Knowing the person and their life history helps, 
as everyone has their own needs, routines, likes and dislikes. 

Here are some ideas that may help:

  • Use different tastes, colours and smells. The smell of cooking – for example freshly baked bread – can stimulate someone’s appetite.
  • Try different types of food and drink with varying temperatures and textures, such as milkshakes or potato wedges.
  • Try not to overload the plate with too much food – small and regular portions often work best. Consider serving half portions to keep hot food from going cold and losing its appeal.
  • Give the person food they like. However, remember that a person’s food preferences can change as their dementia progresses.
  • Don’t stop someone from eating dessert if they haven’t eaten their savoury meal. They may prefer sweet tastes to savoury. Although bear in mind any health or dental concerns with eating too much sugar.
  • Don’t assume the person has finished because they have stopped eating. Give the person gentle reminders to eat and remind them what the food is.
  • If the person is agitated or distressed, don’t put pressure on them. Wait until they are calm and less anxious before offering food and drink.
  • Use eating and drinking as an opportunity for activity and social stimulation. It may be an opportunity to talk about food from their childhood, which could help to encourage their appetite. They could also help with preparing the food – see ‘Improving the eating experience’ on page 18.
  • If the person doesn’t want to eat meals at set times or at a table, make finger foods and snacks available instead. This could include sausage rolls, falafel, samosas, spring rolls, sandwiches, slices of fruit or vegetables. Some full meals could be served in this way too – for example a roast dinner, as long as it’s presented in easy-to-hold pieces.
  • Look for opportunities to encourage the person to eat. For example, if they’re awake for much of the night, nighttime snacks may be a good idea.
  • If the person refuses food, try again a bit later.

Overeating and dementia

Some people with dementia may eat too much or too often. They may have forgotten that they’ve recently eaten, or worry about when the next meal is coming. 

If a person is overeating, they may also eat foods that their doctor has told them to avoid. They might frequently ask about or search for food. This can be stressful for them and the people around them.

Certain types of dementia, such as frontotemporal dementia, may be more likely to cause overeating and other changes to eating behaviour. These may include changes in dietary preference and obsession with particular foods.
 

  • Make sure the person has something to do, so they don’t feel bored or lonely, which may lead to ‘comfort eating’.
  • Consider the person’s life history. If there have been times when they haven’t known when the next meal is coming, they may need reassurance that they don’t need to overeat.
  • Divide the original portion into two and offer the second one if the person asks for more.
  • Fill most of the plate with salad or vegetables.
  • Make sure the person is well hydrated as they may be mistaking thirst for hunger. Offer them a drink with their meal.
  • Leave bite-sized fruit or healthy snacks, such as chopped bananas, orange segments or grapes, within reach for the person to snack on when they want to.
  • Offer the person a low-calorie drink instead of more food. Consider not having certain foods in the house, or substituting them with low-fat or low-calorie versions.
  • If the person has developed a strong preference for particular foods and is not eating enough of other foods, or if they are struggling with excess weight gain, ask the GP for a referral to a dietitian. 
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