Maximizing outcome of dementia treatment: the role of nutrition.

The dementia syndromes are multifactorial regarding etiology, prevention, diagnosis,therapy, and rehabilitation, which include genetics, histopathology, biochemistry as well as sociopsychology, clinical medicine and caring sciences. This review concentrates on nutritional aspects. This includes body composition, where sarcopenia and water deprivations are important issues. Body weight and body water decrease with age which together with the well-known deterioration of thirst perception in old age may give rise to e.g., circulatory collapse and confusion, which is such a common symptom in the elderly not the least in demented patients. We have shown that an improved meal environment in nursing home patients markedly improves the psychosocial and nutritional situation. Aspects on feeding behavior have been shown to be important as well. Epidemiologically, recent 18-year longitudinal data from the gerontological and geriatric population studies in Göteborg, Sweden(H70) suggest that overweight at high ages is a risk factor for dementia, particularly Alzheimer's disease, in women. Furthermore, overweight and obesity are important contributors to the presence of white matter lesions in the elderly.