NUT Wk 14 - Dementia

Question 1

At what age does cognition typically peak, and how does it change over time?

Answer 1

Cognition peaks around 30 years of age and slowly declines with age. Mild changes in cognition are a normal part of aging.

Question 2

What is the difference between normal aging and cognitive impairment?

Answer 2

Normal aging involves mild cognitive changes, but mild cognitive impairment and dementia indicate a greater decline in cognition than expected for someone’s age.

Question 3

What are some conditions often associated with dementia?

Answer 3

Dementia is often part of other diagnoses, such as Parkinson’s disease, Alzheimer’s disease, chronic traumatic encephalopathy (traumatic brain injury), and vascular dementia.

Question 4

What is Mild Cognitive Impairment (MCI)?

Answer 4

cognitive decline is greater than expected for age, education, or development but do not affect the ability to carry out activities of daily living (ADL)

Question 5

What is Dementia?

Answer 5

Same as with MCI but ADLs are affected

Question 6

What are the common age-related body changes in muscle and bone?

Answer 6

Muscle loss (3–8% per decade after 30, increasing after 60), bone loss, and an increase in body fat are common age-related changes.

Question 7

How does aging affect cardiovascular and renal systems?

Answer 7

Aging reduces cardiovascular fitness and causes arteriosclerosis, while renal changes decrease function and make it harder to maintain fluid balance.

Question 8

What gastrointestinal changes occur with aging?

Answer 8

Reduced digestive secretions, loss of gastric acid (affecting absorption of B12, thiamine, folate, calcium, and iron), increased transit time (constipation), and early satiety.

Question 9

How do caloric and macronutrient needs change with aging?

Answer 9

Caloric needs generally decrease but depend on activity. Complex carbohydrates (45–65% of energy) and healthy fats (20–35%) are emphasized. Protein needs vary based on health status, ranging from 0.8 g/kg to 1.5 g/kg body weight.

Question 10

What are the recommendations for calcium, iron, and sodium intake in older adults?

Answer 10

Calcium: Increases to reduce bone loss.

Iron: Postmenopausal requirements drop; supplementation is not recommended.

Sodium: Limited to 2300 mg to avoid fluid retention and high blood pressure.

Question 11

Why is vitamin optimization important for older adults, and which vitamins are emphasized?

Answer 11

Aging affects vitamin needs:
- Folate: Prevents homocysteine-related atherosclerosis.
- B6: Preserves muscle mass.
- B12: Needed due to reduced absorption.
- Vitamin D: Supports calcium needs and reduced outdoor time.

Question 12

How does aging affect fluid intake requirements?

Answer 12

Aging alters the thirst mechanism, reduces kidney water conservation, and increases risks of dehydration or overhydration. General fluid needs are 1.2–3 L based on size and activity.

Question 13

Why is understanding the cause of dementia important for nutritional support?

Answer 13

Nutritional support depends on the cause of dementia. Alzheimer’s disease is the most common cause (up to half of cases) and serves as the focus for many therapeutic options.

Question 14

What should always be considered when creating a nutritional plan for dementia patients?

Answer 14

Consider comorbidities, medications, and age-related changes to nutritional needs.

Question 15

What is the role of prevention in dementia?

Answer 15

Many dementia risk factors are preventable. Recognizing their lifelong impact is crucial because treatment after diagnosis is challenging.

Question 16

What dietary components are associated with neuroprotection?

Answer 16

Neuroprotection involves antioxidants and polyphenols, such as:

Antioxidants: Pinocembrin (honey), Naringenin (citrus), Luteolin (radicchio).
Polyphenols: Curcuminoids, Allicin (garlic), Alpha lipoic acid (spinach, broccoli).

Question 17

What are some therapeutic diets that reduce the risk of Alzheimer’s disease?

Answer 17

• Mediterranean diet: Rich in healthy fats, fruits, and vegetables.
• Healthy Japanese diet: Emphasizes fish, rice, and vegetables.
• MIND diet: Combines Mediterranean and DASH diets to promote brain health.

Question 18

What is the MIND diet, and why is it important?

Answer 18

The MIND diet is a combination of the Mediterranean and DASH diets designed to delay neurodegenerative changes and promote brain health.

Question 19

What are the main food recommendations of the MIND diet for brain health?

Answer 19

• Whole grains: 3+ servings/day.
• Vegetables: 1+ servings/day (other than leafy greens).
• Green leafy vegetables: 6+ servings/week.
• Nuts: 5+ servings/week.
• Beans: 4+ meals/week.
• Berries: 2+ servings/week.
• Poultry: 2+ meals/week.
• Fish: 1+ meal/week.

Question 20

What fats and oils are recommended in the MIND diet?

Answer 20

Use mainly olive oil for added fat

Question 21

What foods are limited or avoided in the MIND diet?

Answer 21

Pastries and sweets: Less than 5 servings/week.
Red meat: Less than 4 servings/week.
Cheese and fried foods: Less than 1 serving/week.

Question 22

What impact does following the MIND diet have on Alzheimer’s disease risk?

Answer 22

High engagement: 53% lower risk of Alzheimer’s.
Moderate engagement: 35% lower risk.

Question 23

How does the MIND diet affect cognitive health and brain function?

Answer 23

Participants with higher MIND diet scores had:
- Better cognitive functioning.
- Larger brain volume.
- Higher memory scores.
- Lower risk of dementia.
- Slower cognitive decline, even in those with Alzheimer’s or stroke history.

Question 24

What strategies can help individuals with dementia during mealtimes?

Answer 24

Use modified utensils and dishes, offer finger foods, allow adequate time, protect mealtimes, and reduce distractions to minimize frustration.

Question 25

What are key considerations for calorie targets in dementia patients?

Answer 25

• Prevent weight loss from inadequate intake, depression, or self-feeding difficulties.
• Increase calorie targets for individuals who pace or wander frequently.

Question 26

What dietary modifications can support individuals with dementia?

Answer 26

• Offer nutrient-dense foods to address early satiety.
• Include oily fish for omega-3 fatty acids.
• Ensure potassium intake to prevent muscle loss.
• Vary fruits and vegetables for antioxidant diversity.