September 29, 2004
Setting the table with boldly colorful cups and plates may be an easy and practical way to help loved ones with Alzheimer's stay properly nourished, a new study reports. Researchers found that using colorful tableware appeared to make it easier for those with advanced Alzheimer's disease to see the food and beverages in front of them, leading them to eat and drink at least 25 percent more at mealtimes.
Men and women with Alzheimer's often have trouble with visual perception and distinguishing objects from one another, particularly as the disease progresses. That visual deficit may make it difficult for them to distinguish a plate full of food from a patterned tablecloth, for example, or a cup of milk from the mug that holds it. Up to 40 percent of those with Alzheimer's lose so much weight as the disease advances that it threatens their overall health. Depression and loss of appetite probably account for some of this weight loss, doctors believe. But using brightly colored, easy-to-see tableware may be a relatively simple way to help such people get better nutrition, this study suggests.
In the study, which appeared in the August 2004 issue of the journal Clinical Nutrition, researchers from Boston University in Massachusetts studied nine elderly men (average age 82) with advanced Alzheimer's. They were being cared for in a long-term-care facility but were able to eat on their own. During the first 10 days, each was served meals on white cups and plates, using stainless-steel flatware. Typical meals included chicken, mashed potatoes, and milk, which did not contrast sharply with the white tableware. The researchers recorded how much the men ate at lunch and dinner.
The men in the study were then fed during different 10-day periods using tableware of different colors. Some of the time, they were served meals on bright red or bright blue plates and cups that contrasted sharply with the food and drinks being served. They were also fed using softer, low-contrast tableware in shades of pastel red and blue, alternating with a return to the standard white tableware. During all these study periods, their food and drink intakes were carefully measured.
Using the bright-red cups, plates, forks, and spoons increased food intake by nearly 25 percent, and drink intake by a whopping 83 percent, compared to using white tableware. Similarly, the use of bright blue tableware boosted food intake by 25 percent and drink intake by almost 30 percent. The soft red- and blue-pastel colored dishes, however, did little to boost food or drink intake compared to the standard white tableware. The increase in food and drink consumption was most pronounced during lunchtime, rather than at dinnertime.
"The results of this study are encouraging," the researchers concluded. "Caregivers should consider implementing such interventions to increase food and liquid intake."
These findings highlight the simple steps that can be taken at home or in a facility to aid the care of those with Alzheimer's. Advocate Joanne Koenig Coste offers many additional tips in her book Learning to Speak Alzheimer's. Among her suggestions:
Brighten the home. Use bright lights to eliminate shadows and dark corners, which can be frightening to the person with Alzheimer's and cause them to become agitated, lash out or be aggressive. Cover mirrors if the patient feels threatened or invaded by the "stranger" who stares back.
Use bright colors and bold contrasts. Paint the bathroom a rich color, for example, to provide an easily recognizable contrast with the white toilet. She describes how her husband would pace the oak floors of her home, avoiding the wooden chairs in the family room. Only after one of her kids placed a bright red pillow on the chair could he clearly make out the chair's outlines -- and feel that he could safely sit down.
Source: Tracey E. Dunne, Sandy A. Neargarder, P.B. Cipolloni, Alice Cronin-Golomb: "Visual contrast enhances food and liquid intake in advanced Alzheimer's disease." Clinical Nutrition 2004 Aug;23(4):533-8.