Diet, Exercise & Health

How can overall health and well-being be maintained in a person who has Alzheimer’s disease?

It’s essential for the person with Alzheimer’s to be under the continual supervision of a qualified medical doctor to stay in the best overall health possible. Poor overall health is associated with more significant symptoms of Alzheimer’s, so maintaining healthy habits may reduce symptoms. Attention must be paid to proper exercise, diet and any new or long-standing health problems. Hearing and vision should also be evaluated regularly and treated appropriately if faltering. Ongoing consultation with a primary care physician may be supplemented with visits to specialists or other health professionals as necessary to address specific needs.

Co-existing medical conditions should be identified and adequately managed, as they may negatively impact Alzheimer’s behaviors. For example, frequent urinary tract infections may increase wandering, and depression disrupts sleep and deepens social withdrawal.

Do people with Alzheimer’s need to follow a special diet?

People with Alzheimer’s should eat well-balanced, nutrient-rich meals, but a special diet is usually not necessary. However, even healthy older people experience changes in eating habits as they age: Food may not smell or taste the same; it may become more difficult to chew and digest food, and our cells may not be able to utilize the energy from food as efficiently. These problems may be more pronounced in people with Alzheimer’s and may be compounded by other challenges posed by the disease. In addition, Alzheimer’s may cause appetite control systems in the brain to malfunction as nerve cells in those areas deteriorate, resulting in extreme eating behaviors (overeating or not eating at all).

In the early stages of the disease, people with Alzheimer’s may have difficulty preparing meals. They may forget they have food in the oven or cook something and forget to eat it. Step-by-step written or verbal instructions delineating what to do to prepare and eat meals may be beneficial in such cases.

Food preparation problems may progress to difficulty eating. Nerve cell death eventually steals the ability to recognize thirst or hunger. At the same time, depth perception may be compromised due to changes in the visual and “mapping” areas of the brain, making the process of eating more frustrating. The person may no longer know how to use a knife or fork and may lose interest in food altogether.

Severe eating problems put the person with Alzheimer’s at risk for weight loss, dehydration, and malnutrition. See your doctor if you notice significant weight loss or changes in eating behavior. Ask about ways to increase your loved one’s food intake and find out if nutritional supplementation might be warranted. Keep in mind that supplements should be used with caution and only under a doctor’s supervision, as they may interact with prescription medications.

Is it important for a person who has Alzheimer’s to exercise?

Maintaining a reasonable level of exercise is important for many reasons, both for overall health and to address issues specific to Alzheimer’s. Exercise can improve mobility and help one maintain independence. In normal people, moderately strenuous exercise has been shown to improve cognitive functioning.

In people with Alzheimer’s, studies show that light exercise and walking appear to reduce wandering, aggression, and agitation. Incorporating exercise into daily routines and scheduled activities can also be beneficial in alleviating problem behaviors. The type of exercise should be individualized to the person’s abilities. Talk with your doctor about what is right.

What kinds of complementary health approaches might benefit a person with Alzheimer’s?

Health treatments for people with Alzheimer’s disease can also employ so-called “complementary” health approaches. These may include herbal remedies, acupuncture, and massage. This area of treatment is presently the subject of a great deal of research, with far more proposed. It’s important to understand that complementary or alternative health approaches, including vitamins and herbal supplements, are not subject to the same kind of critical government review for safety and efficacy that new drugs are, so one must be cautious when considering such approaches. While there are a growing number of legitimate researchers investigating these approaches, there is also a great deal of misinformation in the public domain, and unsubstantiated claims are rampant. Ask your doctor to help you understand the benefits and risks of such approaches, and do not take herbal or vitamin supplements without first discussing it with your doctor since many of these pills can interact negatively with prescription or nonprescription medications.

Gingko biloba, an herbal supplement with antioxidant properties, has been the subject of much hype regarding it’s supposed effects on cognition and memory. Some studies have shown that some people with dementia (of unspecified types) may benefit from gingko biloba supplements, but rigorous evidence of the herb’s effectiveness is so far lacking. More studies are ongoing, including ones that are investigating whether gingko biloba can help improve symptoms of Mild Cognitive Impairment. Like other herbal supplements, gingko biloba can have side effects and may interact with prescription medications, so it should only be taken under a doctor’s supervision.

Acupuncture, a core component of traditional Chinese medicine that has been used for thousands of years to treat all manner of health complaints, has recently been investigated for its use in Alzheimer’s disease. Scientists at two medical institutions, the Wellesley College Center for Research on Women in Wellesley, Mass. and the University of Hong Kong, reported the promising findings of two small studies at a recent medical meeting for Alzheimer’s researchers.

In the Wellesley study, 11 people with dementia (10 with Alzheimer’s, one with vascular dementia, a related condition) were treated with acupuncture twice a week for three months. Tests completed before and after the study measured cognitive function and mood in the study subjects, and an analysis showed that the treatments significantly reduced depression and anxiety. The Hong Kong study, in which eight patients with Alzheimer’s were treated for a total of 30 days each, demonstrated significant improvements in cognition, verbal skills, motor coordination and in an overall measure of the severity of Alzheimer’s symptoms. Additional studies are ongoing to repeat the results and further explore the effectiveness of acupuncture for treating mood and behavioral disturbances associated with Alzheimer’s disease.

Massage can be therapeutic for a number of health conditions, and a great deal of research has documented its benefits in general health. Fewer studies have investigated its usefulness in Alzheimer’s, but there is some evidence that massage therapy may reduce behaviors such as wandering, aggression, and agitation.