Seeing someone close to us aging, whether a parent or a spouse, can sometimes put us on alert. Especially when behavioral changes appear. We notice that he forgets more things, that he struggles for words or that he needs more help on a daily basis. But cognitive disorders do not only concern memory. A change in habits or behavior can also be a signal that should not be ignored.
This can particularly manifest itself at the table. A fine cook becomes a fan of prepared meals. A taste adventurer finds herself eating exactly the same thing every day, or forgetting certain meals.
Should we therefore see the first signs of Alzheimer’s disease? Not necessarily. “But any behavioral modification must lead to questioning and consultation”explains Dr Wilfrid Casseron, neurologist. Above all, it is necessary to observe the nature of the change, its appearance and any other associated symptoms.
Eating disorders are not just about memory
Dementia is a general term for several neurocognitive diseases and disorders. Alzheimer’s disease is the most common form, but there is also frontotemporal dementia (FTD).
This distinction is important when observing changes at the table. In some behavioral forms of FTD, changes in personality and behavior may appear early, sometimes before memory problems are evident. Dietary changes can then be particularly marked.
“Eating behavior disorders are mainly encountered in frontotemporal dementia, particularly in behavioral forms”, explains Dr. Casseron.
In Alzheimer’s disease, eating difficulties may be more linked to memory problems and difficulties in carrying out certain complex tasks. A person may forget to eat, no longer know if they have already had their meal or no longer be able to cook as before.
These differences provide a better understanding of the changes observed, but no single dietary habit alone is enough to make a diagnosis.
He doesn’t cook like he used to
Sometimes it’s a particularly noticeable change in someone who has always loved cooking. She prepared elaborate meals, did her shopping, followed recipes… then gradually began to buy ready-made meals or eat much simpler foods.
In Alzheimer’s disease, certain complex tasks can become difficult to perform. Planning a meal, doing the shopping, following several steps of a recipe and then cooking requires mobilizing different cognitive abilities.
“Patients who used to enjoy cooking do simpler things simply because they can no longer do it,” explains the neurologist.
It is therefore not necessarily a lack of desire. The person may simply no longer be able to carry out certain actions or organize the different steps necessary to prepare a meal.
This change becomes especially interesting to observe when it is accompanied by other difficulties in daily life.
He forgets to eat… or forgets that he has already eaten
In a person living alone, this change can be difficult to spot. Some meals are skipped, schedules become irregular or the loved one no longer knows if they have already eaten lunch.
In Alzheimer’s disease, memory problems can lead to forgetting a meal or no longer remembering having taken it. Dr. Casseron also mentions a possible disruption of hunger and satiety signals.
The person may then eat too little or, on the contrary, start eating again shortly after.
“We must also monitor the very concrete consequences: weight loss, unbalanced diet or food kept too long.”
The contents of the refrigerator can also be a valuable indicator. The neurologist talks about people who go shopping and then leave certain products for several weeks, at the risk of consuming expired food.
He always eats the same thing
Another possible change: the person no longer varies their diet. She systematically asks for the same pasta, the same ravioli, the same chicken or the same dish, day after day.
“This behavior may correspond to a form of stereotypy, that is to say the unusual repetition of the same behavior. It is easier to say “I want that” than to make a complex choice”explains Dr. Casseron.
The person may have more difficulty comparing several possibilities and making a decision.
This rigidity can also appear in other areas: always wanting to follow the same ritual, wearing the same clothes or reproducing certain gestures repetitively.
When it appears early and integrates with other behavioral changes, this tendency can notably direct the doctor towards frontotemporal dementia.
He suddenly begins to crave sugar
Sometimes it’s the change that surprises those around you the most: a person who rarely ate desserts suddenly starts looking for cookies, candies, pastries or other very sweet foods.
“The attraction to sugar, what we call craving, is also a behavior that we can observe in frontotemporal dementias,” explains Dr. Casseron.
In these diseases, certain brain regions involved in impulse control and the reward circuit can be affected. Eating behavior then becomes more disinhibited: the person has more difficulty controlling a desire and may repeatedly seek out foods that provide a feeling of pleasure.
An attraction to sugar can also be observed in Alzheimer’s disease. “Certain neurodegenerative diseases are indeed accompanied by disorders of smell. When this diminishes, foods can seem bland and simple flavors, such as sweet, become particularly attractive.”
He eats a lot more than before
Another situation to watch out for: a person who suddenly eats a lot, seems to no longer feel full or constantly asks for food.
In frontotemporal dementias, this hyperphagia may be linked to damage to the frontal regions involved in impulse control and the regulation of eating behavior.
“Families sometimes tell us that they can’t stop eating.”reports the neurologist.
The person may then have difficulty stopping, even after eating enough. This hyperphagia can be accompanied by a preference for certain foods, particularly sweet products.
Ultimately, excessive consumption can lead to weight gain or a dietary imbalance, with consequences in particular on cardiovascular health.
How to react to a loved one who changes their habits?
The first thing to do, according to the expert, is not to turn meals into a showdown.
“We must not be in head-on opposition”advises Dr. Casseron. Systematically banning certain foods or increasing criticism risks increasing tensions.
It is better to look for practical solutions to preserve a balanced diet as much as possible.
“If a loved one constantly asks for sweet foods, we can, for example, offer naturally sweet foods or preparations less rich in sugar, while maintaining a varied diet.”
It is also important to maintain regular meal times. Some people lose their time markers and may start eating at unusual times.
“Maintaining a certain rhythm allows us to maintain benchmarks during the day.”
When the person lives alone, those around them can also regularly check the groceries and the refrigerator: expired food, lack of food, diet that has become very repetitive or, on the contrary, accumulation of certain products are all elements to monitor.
Don’t take these changes for a whim
Finally, remember that for those around you, these behaviors can be confusing. “Seeing a parent who suddenly refuses prepared meals, asks only for sugary foods or eats the same thing several times in a row can give the impression that they are “making a fuss”” assures the neurologist
But when a neurocognitive disorder is involved, this behavior can be directly linked to the illness. “Above all, we must explain to those around us that it is linked to the illness, that it is not a whim“, insists Dr. Casseron.
The objective is therefore not to be alarmed at the slightest dietary change. On the other hand, when an elderly person significantly and lastingly changes the way they eat, cook or behave at the table, it is important to speak to a health professional.
Even more so if this change is accompanied by other modifications: difficulties in everyday activities, loss of autonomy, change in personality, memory problems or unusual behavior.
Observing these changes as a whole allows the doctor to better direct the examinations and, if necessary, to investigate the origin of these changes.