Anorexia In Alzheimer Disease
AD is generally associated with a progressive change in nutritional behavior. Anorexia may occur in the late stage of the disease and contribute to the associated weight loss. It may be due to physical changes , neuropsychiatric disorders associated with the disease , a change in autonomy and dietary habits, or changes in neurotransmitter concentrations .
In summary, several epidemiologic studies have indicated an association between AD and weight loss. This weight loss could occur throughout the disease process, but it could be more common as the illness becomes more severe and anorexia develops. According to some authors , weight loss could be a manifestation of the disease itself. The etiology of weight loss in AD appears multifactorial and some hypotheses have been proposed to explain it ; however, none of these hypotheses has been proven.
General Health And Weight
For each persons height, a range of healthy weights has been defined. Dividing an adults weight in kilograms by the square of height in meters gives a number called the Body Mass Index . Its not a perfect standard, but its often used to identify the lines that separate healthy weight from overweight, and overweight from obese. Getting to a healthy weight and staying there is very important for good health. Too much body weight often means too much fat tissue, and fat tissue can have dangerous effects on health. Overweight or obesity, too, increase the risk for many medical diseases. In the United States, more than a third of adults are obese. The medical cost each year for an obese adult is estimated to be $1,429 higher than for someone of normal weight.1 Some scientists point with alarm to the increase in obesity. They warn that this is going to raise the rate of Alzheimers disease development in our population, which is already increasing due to higher numbers of people who are older or overweight.2
How Can Weight Loss In Patients With Alzheimers Disease Be Treated
Treatment should be focused on the identified causes of weight loss. If other health problems are suspected to contribute to weight loss, they need to be identified and treated. Current medications that are no longer required should be discontinued. Prescription medications, over-the-counter products and supplements that are thought to be a source of weight loss should be discontinued and replaced with medications that are not associated with weight loss. An appetite stimulant, such as megestrol acetate , dronabinol , mirtazapine , or growth hormone secretagogues may be prescribed.
A speech therapist may recommend a feeding strategy if there are reversible causes for the eating problems.
Besides The Presence Of Other Health Problems And Medication Side Effects Are There Other Reasons Persons With Alzheimers Disease Lose Weight
Other reasons for weight loss in persons with Alzheimers disease include:
- More calories being burned. Individuals with Alzheimers disease may lose weight because they may burn more calories than elderly people without the disease. People with dementia frequently pace, wander, and are more likely to be in motion activities that burn more calories.
- The effects of Alzheimers disease itself and aging. Food preferences may change as dementia progresses. Favorite foods may no longer be favorites. Certain food types may become more desired . Vision or sense of smell or taste may become impaired, which makes finding the food and stimulating the appetite more difficult. If the individual with Alzheimers disease is delusional, they may not eat because they fear something, hear voices, or may be distracted during dining and leave the table before finishing the meal. People with advanced Alzheimers disease may lose the ability to recognize foods or forget how to use utensils to bring food into the mouth even though they may be hungry. They can also forget how to chew and swallow food. In addition, patients can also lose weight if they can no longer communicate health problems that are making it less desirable to eat, such as gastrointestinal pain and discomfort.
Other events in the lives of the elderly, such as grief and mourning the loss of a spouse or life-long friends as well as social isolation, can also lead to weight loss.
Pillar #: Vascular Health
Theres more and more evidence to indicate that whats good for your heart is also good for your brain. Maintaining your cardiovascular health can be crucial in protecting your brain and lowering your risk for different types of dementia, including Alzheimers disease and vascular dementia. And of course, addressing heart-health issues can also help you to lower your risk for a future heart attack or stroke.
Tips To Control Hunger
While you may feel its a good thing that your loved one is eating and keeping their weight on, this can lead to its own problems, not the least of which is an extremely uncomfortable feeling after eating too much. This can lead to nausea, vomiting and acid reflux. So, while you dont want to put your loved one on a diet, especially as they go through hospice, there are ways you can help them control their hunger on a daily basis.
Try these tips to keep them comfortable and healthy:
Pillar #: Regular Exercise
According to the Alzheimers Research and Prevention Foundation, regular physical exercise can reduce your risk of developing Alzheimers disease by up to 50 percent. Whats more, exercise can also slow further deterioration in those who have already started to develop cognitive problems. Exercise protects against Alzheimers and other types of dementia by stimulating the brains ability to maintain old connections as well as make new ones.
Aim for at least 150 minutes of moderate intensity exercise each week. The ideal plan involves a combination of cardio exercise and strength training. Good activities for beginners include walking and swimming.
Build muscle to pump up your brain. Moderate levels of weight and resistance training not only increase muscle mass, they help you maintain brain health. For those over 65, adding 2-3 strength sessions to your weekly routine may cut your risk of Alzheimers in half.
Include balance and coordination exercises. Head injuries from falls are an increasing risk as you age, which in turn increase your risk for Alzheimers disease and dementia. As well as protecting your head when you exercise , balance and coordination exercises can help you stay agile and avoid spills. Try yoga, Tai Chi, or exercises using balance balls.
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Long Distance Bicycle Ride
Of course, when riding a bicycle over a long distance, you need a level of endurance and resilience, but this is another effective method to lose weight by cycling. Professional cyclists are known to convert long distances during bike tours, and it usually reflects in their sturdy physiques. Hence, it has become a proven method of losing body weight. This method implies that you drag your cycling over a long distance, thereby burning a lot of fat in the process.
You don’t have to go long distances for this method because a 2 hours ride in any direction you face should suffice for your weekend rides. If you continue to do this for more than eight weeks, you will be amazed at the results.
Are There Certain Medications That An Elderly Person Or Person With Alzheimers Disease May Be Taking That Are Known To Cause Weight Loss
Weight loss is a side effect of many medications that an elderly person or person with Alzheimers disease may take. The types of medications include:
- Cardiac drugs. Including drugs to treat cholesterol heart failure, high blood pressure , chest pain , and drugs to reduce fluid buildup
- Neurologics and psychotics. Including drugs used to treat depression, anxiety, seizures, bipolar disorder, schizophrenia, Parkinsons disease and Alzheimers disease
- Bone and joint and pain drugs. Including drugs to treat osteoporosis, arthritis, gout, pain , and lupus
- Endocrine drugs. Including drugs to treat thyroid disease and diabetes
- Others. Including aspirin, some antibiotics, cold products, allergy products, iron, potassium, alcohol and nicotine, drugs used to treat involuntary muscle movement
Some Hypotheses To Explain Weight Loss
Weight loss in AD occurs frequently in the first stages of the disease, although patients usually have adequate energy intakes. Many hypotheses have been proposed to explain the weight loss.
Atrophy of the mesial temporal cortex
The mesial temporal cortex , which is involved in feeding behavior and memory, is affected in the primary stages of AD and continues to be a site of major AD pathology as the disease worsens. Grundman et al showed in AD that a low body mass index correlates best and specifically with atrophy of the MTC. They suggested that there is a connection between limbic system damage and low body weight in AD. Atrophy of the MTC might contribute to weight loss through additional mechanisms other than cognitive impairments . Moreover, some disturbances associated with weight loss, such as increased cortisol and tumor necrosis factor concentrations or decreased estrogen concentrations , worsen atrophy of the MTC and, consequently, dementia itself.
Higher energy requirements
How Can Dementia Affect A Person’s Appetite
A person with dementia may lose interest in food. They may refuse to eat it or may spit it out. The person may become angry or agitated, or behave in a challenging way during mealtimes.;
If a person isnt 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.;
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Insulin And The Brain
Excess weight itself, though, has its own special dangers concerning the brain. Most of the attention about this has focused on the important pancreatic hormone, insulin. Increased weight is linked with resistance to the metabolic effects of insulin. This is true even in people who are not obese or diabetic. When the body becomes resistant to insulin, the pancreas responds by churning out more of the hormone until the organ fails, resulting in type 2 diabetes.
Extra insulin in the bloodstream actually interferes with the brains energy supply by lowering the amount of fuel that gets into the brain. Insulin, we are also learning, has important direct effects on the brain that are reduced with resistance.
Insulin itself crosses through the brains protective security system and attaches to special receptor molecules on brain cells. These receptors are located in synapses in brain areas that need to work properly in order to make memories. Synapses are structures that permit a neuron to pass an electrical or chemical signal to another neuron.
Among other actions, insulin influences the process that helps to preserve long-term memories.3 Finally, insulin has effects on the brains energy metabolism, and has a regulatory effect on how the brain gets rid of toxic amyloid, and other important brain functions.
The Relationship Between Alzheimer’s Disease And Weight Loss: How Can It Best Be Studied
The relationship between WL and AD is complex and has yet to be fully elucidated. To clarify their temporal and aetiologic links and to help us to identify the initial signs of cognitive symptoms of AD and weight changes with a reasonable degree of reliability, only observational studies conducted for an adequately long time with frequently scheduled cognitive and nutritional visits should be considered. In the literature, however, either the studies are not long enough or the follow-up visits are scheduled at excessively long intervals, so they enable no definite conclusions to be drawn.
Given the lengthy latency period of AD, it is hard to define a maximum time interval that could elapse between the onset of WL and cognitive impairment for the WL to be considered as risk factors for dementia or one of its signs. WL starting more than a year before the onset of dementia could feasibly be seen as a risk factor for the latter.
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Dont Leave It Too Late To Lose Weight Alzheimers Researchers Warn
Lauren Hurley/PA Wire
A study has found that maintaining a healthy weight could help people who are already experiencing mild Alzheimers but also found that being overweight in mid-life could have an impact on brain health in older age.
The researchers from Sheffield and the University of Eastern Finland stressed that that their study does not show that obesity causes Alzheimers but warned people to think about their weight.
Professor Annalena Venneri, from the University of Sheffields Neuroscience Institute and NIHR Sheffield Biomedical Research Centre, said: The diseases that cause dementia, such as Alzheimers and vascular dementia, lurk in the background for many years, so waiting until your 60s to lose weight is too late.
Prof Venneri said: More than 50 million people are thought to be living with Alzheimers disease and, despite decades of groundbreaking studies and a huge global research effort, we still dont have a cure for this cruel disease.
Prevention plays such an important role in the fight against the disease.
It is important to stress this study does not show that obesity causes Alzheimers, but what it does show is that being overweight is an additional burden on brain health and it may exacerbate the disease.
We need to start thinking about brain health and preventing these diseases much earlier.
Educating children and adolescents about the burden being overweight has on multimorbidities including neurodegenerative diseases is vital.
Eating Appetite Changes And Weight Loss In Dementia
When we think of dementia, we typically focus on memory loss, difficulty finding the right word, disorientation or poor decision-making skills. These cognitive aspects are central to Alzheimer’s and other kinds of dementia. However, other challenges in caring for the person with dementia include those related to activities of daily functioning, such as eating, drinking, bathing, and dressing. This includes difficulties in eating and appetite changes, which often result in unintended weight loss.
According to a study of more than 16,000 adults published in Alzheimer’s & Dementia: a Journal of the Alzheimer’s Association, unplanned weight loss is strongly correlated with dementia severity.
Adequate nutrition is critical to maintaining the highest functioning possible for each person, perhaps especially in dementia, where needs like hunger might not always be fully communicated.
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Tips For Starting And Sticking With An Exercise Plan
If youve been inactive for a while, starting an exercise program can be intimidating. But remember: a little exercise is better than none. In fact, adding just modest amounts of physical activity to your weekly routine can have a profound effect on your health.
Choose activities you enjoy and start smalla 10-minute walk a few times a day, for exampleand allow yourself to gradually build up your momentum and self-confidence.;
Involuntary Weight Loss Due To A Lower Energy Intake
As AD progresses, patients usually also develop dietary problems, neglecting or forgetting to eat or becoming averse to some foods, and this can lead to a lower oral intake and a consequently accelerated WL. A decline in food consumption has been observed right from the first stage of AD, probably due to early changes in the appetite-regulating mechanisms. The exact reasons for a lower food intake have yet to be clearly defined, but changes in the brain regions involved in hunger control, a declining sense of smell and taste, and an earlier satiety due to a greater sensitivity to cholecystokinin are all potential contributors. In particular, some brain areas are known to have a role in regulating food intake, as medial temporal cortex, anterior cingulate cortex and olfactory epithelium, are frequently involved in amyloid deposition.
Concomitant chronic diseases, depressed mood and several types of medication could also contribute to a lower food intake by determining anorexia, constipation and an altered sense of smell and taste. In addition, pro-inflammatory cytokines and chemokines , the levels of which are higher than normal in AD due to neuro-inflammation, may mimic the action of appetite-regulating peptides and suppress feeding by taking effect directly on the glucose-sensitive neurons in the hypothalamic sites of satiety and hunger.
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Stage : Initial Mild Stage
Initial mild stage is also one of the vascular dementia that people should know and try to reduce its signs and symptoms for good.
This is known as the starting of this kind of disorder. During this stage, he or she will become more forgetful than ever before.
They will have difficulty in remembering what they were talking about and what they need to do. Besides, they will find it hard to concentrate at work, thus decreasing work performance. People can get lost more often and feel difficult to find the right words.
This stage of vascular dementia often begins to show signs and symptoms, about 5-7 years before the prediction of the presence of this disorder. Also, there is no diagnosis of vascular dementia.
This is in brief one of the vascular dementia stages, so people should not look down, yet work with their doctors and familiars; in order to manage their conditions.
Less Fat And Weight Loss
You might ask, can cycling lose weight? And as you might have guessed too, the answer is yes. Cycling is a form of exercise on its own; there is contraction and constriction of muscles, leading to heat generation. This heat generated helps burn the excess fat in your body and ensures you lose body weight.
Generally, riding a bike is an excellent way to keep your cardiovascular and muscular parts in shape. It can help you ensure efficient flow of blood, thereby ensuring the welfare of your heart and lung. This, in turn, increases the rate of metabolism and breaking down more fats in the body, which finally reduces the body weight.
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