Alzheimer’s disease (AD) is a progressive and irreversible neurodegenerative disorder characterized by a decline in cognitive and functional abilities, loss of episodic memory and language skills, neuropsychiatric symptoms, and premature death. Currently, dementia affects approximately 25 million people worldwide, and it is estimated that due to increased life expectancy, by 2050 at least 115.4 million people will be living with this disease.

At the biochemical level, Alzheimer’s disease manifests through the accumulation of amyloid-beta (Aβ) peptide deposits and the formation of neurofibrillary tangles of proteins in the brain. It has been shown that the implementation of certain measures can slow disease progression, among which nutritional approaches are becoming increasingly important (Miculas et al., 2023).

Recent findings indicate that the onset and progression of Alzheimer’s disease (AD) are strongly correlated with lifestyle factors, including dietary patterns. Appropriate nutritional interventions may be an effective approach to delaying neurocognitive decline and reducing the risk of the onset and progression of AD. Adopting a healthy diet—characterized by high intake of plant-based proteins, probiotics, legumes, and omega-3 polyunsaturated fatty acids, along with low intake of saturated fats, animal protein, and refined sugars—can reduce the risk of neurocognitive disorders (Pistollato et al., 2018; Abduljawad et al., 2022).

In addition, vitamins and minerals play many vital roles, including modulating brain health and cognitive function. Therefore, supplementation with these micronutrients may help maintain adequate cognitive activity or even prevent dementia (Karthika et al., 2022).

Several studies suggest that consuming foods rich in antioxidants and anti-inflammatory compounds—such as those found in fruits, nuts, vegetables, and fish—can reduce age-related cognitive decline and the risk of developing various neurodegenerative diseases. Antioxidants are compounds that can inhibit or prevent oxidation, thereby protecting against the effects of reactive oxygen free radicals. Foods with high antioxidant content can act as neuroprotective agents against neuronal cell death. Common antioxidant vitamins include vitamins A, E, and C (Zeng & Wang, 2001). In addition, plant-derived antioxidants include polyphenolic or phenolic compounds, flavonoids, cinnamic acid derivatives, coumarins, tocopherols, and organic acids (Melzer et al., 2021).

Beyond antioxidants, certain dietary components also play a role in brain protection. One of these is omega-3 fatty acids, particularly docosahexaenoic acid (DHA), which is found in foods such as salmon, tuna, sardines, and chia seeds. B-complex vitamins—especially vitamins B6, B12, and folate—play an important role in homocysteine metabolism. Natural sources of B vitamins include meat, fish, eggs, green leafy vegetables, and whole grains.

For people with Alzheimer’s disease or dementia, poor nutrition can worsen behavioral symptoms and lead to weight loss. The following basic nutritional tips may help improve the health of people with Alzheimer’s:

• Provide a balanced diet with a variety of foods, such as vegetables, fruits, whole grains, low-fat dairy products, and lean protein sources.
• Limit foods high in saturated fat and cholesterol. Reduce consumption of unhealthy fats for heart health, such as butter, solid fats, lard, and fatty cuts of meat.
• Reduce intake of refined sugars. Refined sugars provide calories but lack vitamins, minerals, and fiber. To satisfy sweet cravings, healthier options include fruit or baked goods sweetened with fruit juice. However, it should be noted that in the later stages of Alzheimer’s disease, when loss of appetite becomes an issue, adding sugar to foods may encourage eating.
• Limit foods high in sodium and reduce salt use. Excessive sodium intake can affect blood pressure. As an alternative, use spices or herbs to season food.
• Maintain adequate hydration by ensuring sufficient fluid intake, such as drinking small glasses of water or other fluids throughout the day, or consuming foods with high water content, such as fruits, soups, milkshakes, and smoothies.

Possible Causes of Poor Appetite in People with Alzheimer’s

1. Inability to recognize the food being served.
2. Ill-fitting dentures.
3. Medications, such as newly prescribed drugs or dosage changes, which may affect appetite.
4. Lack of exercise and physical activity, which can reduce appetite.
5. Reduced sense of smell and taste. People with Alzheimer’s or dementia may refuse to eat because food no longer smells or tastes as appealing as before.

In the middle and late stages of Alzheimer’s disease, swallowing difficulties may lead to choking and weight loss. This can be prevented with the following tips:

• Prepare foods that are easy to chew or swallow. Puree foods, cut them into bite-sized pieces, or serve soft foods such as applesauce, cottage cheese, and scrambled eggs.
• Be alert to signs of choking. Avoid foods that are difficult to chew, ensure the person is sitting upright with the head slightly tilted forward. If the head tilts backward, gently reposition it forward. At the end of meals, check the person’s mouth to ensure that all food has been swallowed.
• Address decreased appetite. If someone experiences reduced appetite, try preparing some of their favorite foods, consider increasing physical activity, or plan several small meals instead of three large meals.

References

• Miculas, D., Negru, P., Bungau, S., Behl, T., Hassan, S., & Tit, D. (2023). Pharmacotherapy evolution in Alzheimer’s disease: Current framework and relevant directions. Cells, 12, 1–26. https://doi.org/10.3390/cells12010131
• Pistollato, F., Calderon Iglesias, R., Ruiz, R., Aparicio, S., Crespo, J., Dzul Lopez, L., et al. (2018). Nutritional patterns associated with the maintenance of neurocognitive functions and the risk of dementia and Alzheimer’s disease: A focus on human studies. Pharmacological Research, 131, 32–43. https://doi.org/10.1016/j.phrs.2018.03.012
• Abduljawad, A., Elawad, M., Elkhalifa, M., Ahmed, A., Hamdoon, A., Salim, L., et al. (2022). Alzheimer’s disease as a major public health concern: Role of dietary saponins in mitigating neurodegenerative disorders and their underlying mechanisms. Molecules, 27, 1–23. https://doi.org/10.3390/molecules27206804
• Karthika, C., Appu, A., Akter, R., Rahman, M., Tagde, P., Ashraf, G., et al. (2022). Potential innovation against Alzheimer’s disorder: A tricomponent combination of natural antioxidants (vitamin E, quercetin, and basil oil) and the development of its intranasal delivery. Environmental Science and Pollution Research, 29, 10950–10965. https://doi.org/10.1007/s11356-021-17830-7
• Melzer, T. M., Manosso, L. M., Yau, S. Y., Gil-Mohapel, J., & Brocardo, P. S. (2021). In pursuit of healthy aging: Effects of nutrition on brain function. International Journal of Molecular Sciences, 22(9), 5026. https://doi.org/10.3390/ijms22095026