nutrition in cognitive decline

describe the population profile for older age

13 million over 65 years

expected to increase

impact= greater burdens on healthcare/number of people with dementia

list some of the contributing factors for the development of malnutrition in older adults

• clinical factors: disease, drug-nutrient interactions, immune function

• social factors- income, living arrangements

• co-morbidities- chronic health condition

• altered psychology- bereavement, loneliness, confusion

• physical, physiological factors- mobility, senses, vision, taste, smell

what did a cross sectional analysis of eating difficulties in the NDNS show?

25% reported difficulties with crusty bread edentate- no teeth

and 8% dentate with teeth

other foods with difficulties were : raw carrots, apples and steaks

those with edentate with dentures compared to dentate - had lower mean daily intakes of:

beta carotene, folate, vitamin C, magnesium, and potassium

what was the association found in a 13 year longitudinal study of Chinese older adults find?

more teeth resulted in better cognitive function and a slower pace of cognitive decline over time than those with fewer teeth

what did a study looking at the hardness of habitual diet find?

a greater dietary hardness is associated with a better measure of cognitive function

how can the biological link between tooth loss and cognitive decline be explained?

periodontitis- inflammatory gum disease may be link to brain inflammation

poor nutrition or food choices- due to tooth loss- B vitamins may be linked to cognitive decline

decreased mastication- - mastication provides sensory information to the brain - maintaining learning and memory functions

other- reduced income and greater tooth loss

describe dementia

= a syndrome that can be chronic or progressive leading to a fall in cognitive decline

describe the MMSE aims

used to assess cognitive function-

it looks at:

orientation

attention and calculation

memory

language

visuospatial construction

MMSE score - declines with cognitive age

describe alzeimers’s

a form of dementia with a decline in short term memory and cognition

impacts on daily behaviour

describe the relationship between age, food and nutrition:

dementia/cognitive decline →forgetting/non foods, dysfunctional eating patterns ect →impact on nutrition

what was the 2006 hypothesis for the Mediterranean diet and risk for alzeimers’s disease ?

Med diet associated with a lower risk of developing Alzeimers’s disease

Describe the method and findings briefly of the study looking into Med diet and Alzeimers’s risk

adherence to the med diet was based on a nine-item scale

e.g 1, vegetables, 2.fruit 3. legumes with 9 scoring the best adherence and 0 the least

finding: med diet associated with a significantly lower risk of developing Alzeimers disease

up to 39-40% lower risk for those in highest adherence group

what is the MIND diet and what did the study look at?

dietary pattern designed to help protect brain function and reduce cognitive decline, it combines elements of:

• Mediterranean diet

• DASH diet

consumption of healthier brain foods more frequently scored higher e.g green leafy vegetables vs red meats, fried fast food

found the MIND diet slows cognitive decline with ageing

based on food frequency questionnaires and cognitive tests

list some of the questionnaires and tools used in nutritional studies

quality of life measures

diet quality or healthy eating indices

diet specific questionaires e.g med diet

clock drawing test

what are some factors involved in limiting questionnaires and tools?

language 1st or 2nd

hearing loss

vision loss

motor coordination loss

educational level

being unprepared

what did the PREDIMED randomised trial findings show?

both med diet and extra virgin olive oil and med diet and nuts groups showed higher mean MMSE and CDT scores compared to control

what are the possible mechanisms to explain the biological link between the Med diet and Alzeimers disease?

• during Alzeimers’s the rain faces oxidative damage and is vulnerable to damage by oxidative stress

• antioxidants found in complex phenols vit C,E and beta carotene - high concs in the med diet

• the additive impact of the med diet is more significant

• has a reduction in foods which increase inflammatory markers e.g phytochemicals in wholegrains or EVOO are anti-inflammatory

what does the SACN report sum up about food and cognitive decline:

There is no strong evidence that specific nutrients or supplements prevent dementia, but healthy dietary patterns (like the Mediterranean diet) may be associated with lower risk, although causation is not prove

describe the relationship between food habits and nutrition and cognitive decline:

it is bidirectional

risk factors for cognitive decline:

age, cardiovascular conditions, genetic predispositions lots of other risk factors - NOT just nutrition