Preventing weight loss in loved ones with dementia can be a battle

Take a minute to think about food intake and how it varies with age. Some young people can eat anything and anytime they want without the ill effect of weight gain. For many, an obsession with weight loss and gain arrives later in life. We become more intentional about making healthy choices. Perhaps shifting curves awakens us to what should have been just as important when we were young and more svelte.

My mother was never heavy, but she carried a few extra pounds after birthing four kids. She was beautiful and had good self-esteem, but even after losing weight, she thought she was chubby, or, at least, that she used to be. She’d say, “I used to be as wide as I was tall.” She never was. She had dimpled cheeks, but she was born with those, and they grew more beautiful with age.

What’s the point?

My mother was diagnosed with Alzheimer’s disease, the most common form of dementia, in her mid-70s, a decade or so after she’d been diagnosed with diabetes. She always took her health seriously; she ate healthily and exercised faithfully. As her Alzheimer’s progressed, however, weight loss became an issue for the first time.

Ray Burow’s dimpled-faced mother with her love, who had no complaints. (Portrait by Miriam Burow)

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Maintaining a healthy weight was essential to my mother when she was young, but her concern then was with gaining too much weight. When the tables turned, her primary physician didn’t appear worried — at least, not initially. My sister and I continued to ask about Mom’s weight and why it was dropping from her frame. The answer was neither satisfying nor helpful. “It’s just the nature of the disease,” we were repeatedly told.

As her caregivers, we became more frustrated when doctors told us we needed to feed our mother more and that she required fruits and vegetables — something we already knew and were actively trying to help her with. It wasn’t working.

To address her weight loss, we had to get creative.

Muscle loss

My mother wasn’t fat, so losing weight meant she was likely losing muscle. Unfortunately, muscle loss is common with age. According to a 2004 review article published in Current Opinion in Clinical Nutrition and Metabolic Care, “Muscle mass decreases approximately 3-8% per decade after the age of 30 and this rate of decline is even higher after the age of 60.”

Obviously, loss of strength is an accompanying factor. We didn’t want our mother to lose her ability to walk, climb in and out of bed, or get up and down from her chair. Losing muscle would complicate caregiving, but most importantly, it would alter her quality of life.

Pumping iron

We introduced light weight training. When my mother was sitting in her chair or on the edge of her bed, we’d strap on ankle weights, and she’d work out. We kept the weight very light, just enough to add some resistance. She didn’t walk around with the weights on, but with our supervision and instruction, she would lift her legs, switching from one to another after a few reps.

For us, it was an act of faith because we couldn’t see any noticeable improvement, but we figured it couldn’t hurt. She didn’t lose the ability to walk until a few days before she passed away.

Fruits, vegetables, supplements, repeat

Weight loss may be the nature of dementia, as my mother’s physician told us, but perhaps it’s more accurate to say that loss of appetite is the primary contributing factor. People with Alzheimer’s lose interest in eating for a number of reasons. As her disease progressed, my mother lost interest in many things she used to enjoy; maybe eating was one of them. Also, it takes effort to eat. Caregivers must address the specific issues their loved ones face.

Handling a spoon or fork can also be challenging as the disease progresses. Use large utensils that are ergonomic or easier to grip. Healthy finger foods might be the right choice. Colorful, sliced fruits and vegetables and rolled slices of lean cuts of meat might be inviting. We supplemented my mother’s diet with drinks such as Ensure. They helped fill in the gaps and were easy for her to sip through a straw. Yogurt was another food we often gave my mother.

In the late stages of dementia, help your loved one eat by actively feeding them if necessary. Pureeing foods is also an option.

We tried everything we could think of to help prevent muscle and weight loss in my mother. You’ll come up with more ideas that match your loved one’s needs. Let me know what works for you.

Note: Alzheimer’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Alzheimer’s News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Alzheimer’s disease.