Chapter

Principles of Deglutition

pp 411-420

Date:

Disorders of Appetite, Eating, and Swallowing in the Dementias

  • Manabu IkedaAffiliated withDepartment of Neuropsychiatry, Kumamoto University Email author 
  • , John HodgesAffiliated withNeuroscience Research

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Abstract

It is well known that eating problems occur in association with cognitive dysfunction, psychiatric problems, and decline of daily activity in individuals with dementia. Feeding and eating difficulties leading to weight loss are common in the advanced stages of dementia. In contrast to the wealth of information on advanced dementia, relatively few studies have addressed the eating problems in mild dementia and disease-specific behaviors. As the disease progresses, patients with Alzheimer’s disease (AD) have difficulty swallowing due to sensory impairment secondary to dysfunctions in the temporoparietal areas. Vascular dementia patients showed more deficits in bolus formation and mastication of semisolid food, hyolaryngeal excursion, epiglottic inversion, and silent aspiration caused by motor impairments due to disruptions in the corticobulbar tract. The frequencies of appetite change, alterations in food preference toward sweet foods and changed eating habits, are greater in Frontotemporal lobar degeneration (FTLD) than in AD. Appetite increase in FTLD seem to be exacerbated by cultural factors in Western countries. Dementia with Lewy bodies patients showed a higher incidence of swallowing problems and anorexia than AD patients.

Keywords

Eating behavior Swallowing problem Dementia Alzheimer’s disease Vascular dementia Frontotemporal lobar degeneration Dementia with Lewy bodies