Students learn practical application and active learning in lecture content. Designated as a service learning class.
Stacy Forden
Salt Lake Community College
Phys Dys II 1240
Gabe Byars
April 14th, 2024
What Effect Does Diet Have on Alzheimer’s disease?
Alzheimer's Disease (AD) is a form of dementia that presents as a progressive disease that destroys memory and other important mental functions. Currently, there is no cure for the disease, and according to Xu Lou et al. (2023), more than 25 million people worldwide have Dementia, with over 40-60% of that being AD. With the growing number of people getting older increasing due to medical advancements, that number is expected to rise in the next 20 years. Research has suggested that diet can play an important role in the delay of the progression of AD in individuals who have a mild to moderate diagnosis of the disease. In this paper, I will explain what the mechanisms are that contribute to the development of AD, what diets/habits can have negative effects, what diets have been shown to have positive effects, as well as what role an OT professional can play in diet management and education, and asking the question: What Effect does Diet have on Alzheimer’s Disease?
In order to determine what diet may help in AD, it is important to first know what is happening at a biomechanical level in patients who have AD. Although all the causes of the disease are not understood, there are a few markers that patients who have AD have in common. Amyloid-Beta Peptide accumulation in the brain, which makes plaques that block the neurons’ ability to send a signal to other neurons, is present, as well as a protein called Tau that in individuals who have AD, tangle and block the neurons’ ability to get the nutrients it needs to function. When both are in excess, neurons cannot function efficiently, and this leads to neuron death, which in turn leads to memory loss, decreased executive function, and brain atrophy. Inflammation also plays a role in this decline, as well as vascular problems such as diabetes, high blood pressure, and previous stroke that may be comorbidities of the disease (National Institute of Aging, 2024). In addition, hereditary plays a role in the inheritance of the APOE gene. This gene is in charge of making a protein that carries cholesterol and other fats in the bloodstream (National Institute in Aging, 2023). There are different variants that a person can have that are mostly harmless except for the variant APOE 4. “About 25% of people with European ancestry have one copy of APOE4, which more than doubles their chances of developing late-onset Alzheimer’s. Another 2% to 3% of people have two copies of the variant, which renders them 8 to 10 times more likely to get the disease” (Leggett,2022).
Understanding the risk factors involved in the development of AD is important to figuring out what could potentially help and hinder a person’s risk of developing the disease and delaying the progression. Diet and lifestyle have been something that researchers have been closely studying with the connection to AD. According to Xu Lou et al. (2023) the (western diet) or a diet high in fats with a high glycemic index, refined grains, sugars, and high cholesterol increase the AB peptide stores that have been previously mentioned which create oxidative stress and inflammation. In contrast following a “healthy diet” such as the DASH diet (Dietary approach to stop hypertension), or the Mediterranean diet which feature low consumption of red meats, and high consumption of fruits, vegetables, and whole grains lowers your accumulation of AB peptides which decrease inflammation in the body.
Keeping inflammation low and making sure you have all of your vital vitamins and minerals such as Vitamin D, Omega 3’s, and Vitamin E have been shown in some studies to decrease the symptoms of early/mid stage AD. With evidence of (Ellouze ,2023) Government agencies have made the following recommendation. “Therefore, for overall health and well-being, the American Heart Association and the U.S. government’s Dietary Guidelines for Americans recommend a diet centered around plant-based foods, including fruits, vegetables, whole grains, nuts, and seeds, while also incorporating fish, low-fat dairy products, and lean meat. It is advised to limit or avoid red meat, sodium, saturated fats, sugar, and highly processed foods Ellouze et al. (2023). With knowing what certain foods and diets can do to the body and mind especially in the case of AD it is important to do your own research when deciding on what you believe is best for you and what your client or client’s family may want to discuss with you.
Diet is a difficult thing to maintain and follow for patients with AD due to many factors such as the” patients forget to eat, how to hold and use utensils, develop difficulty in communicating desired foods, chewing, and swallowing. Hence have to be fed by the caretakers in the hospital to ensure that they eat enough food” (Kigozi et al. 2021). Also stated here is that some caretakers do not know the proper nutrition needed, or how to go about feeding their loved ones or patients when they become upset, aggressive, and defiant. Caretakers also note that in hospital settings they do not have enough resource to make sure every patient that has AD is eating and note that sometimes the patients refuse the food given to them because they are accustomed to eating one thing and this confuses and upsets them. Since malnutrition is a risk factor in the increased progression of AD Xu Lou et al. (2023) making sure caregivers have this knowledge is very important for the health of the patient.
So, what role can an Occupational Therapist play in the management of diet in individuals with AD? I think it is important to first break down the problems and concerns that the caregivers, family, and patient have in the ability to provide a healthy diet. Education, functional retaining, ALD retraining, sensory interventions, and memory interventions are just a few ways that Occupational therapy practitioners can assist. In education a practitioner could help provide education to the caregivers, patients, and their families about the different diets and their effects on AD. While they would not be able to suggest a given diet, they would be able to show them the data, so they have the information they need to decide what is right for them. When a diet plan is decide the OT practitioner can help by creating a schedule or helping the client create a grocery list with the foods that correspond.
It was also noted above that some individuals with AD lose functions such as the ability to hold a spoon or fork anymore and this is contributing to malnutrition according to caregivers. OT practitioners can come up with adaptive devices and strategies to teach the caregivers and patients to use to make mealtime a more enjoyable and less stressful situation. This may also decrease caregiver burden if the individual is able to feed themselves again depending on the level of progression of the disease. OT’s can also help with ADL training with errorless learning.
Maintaining a healthy diet can be challenging for individuals with AD due to various factors such as forgetfulness, difficulties in communication and swallowing, and caregiver-related challenges. Caregivers often struggle with proper nutrition knowledge and handling mealtime-related behaviors of AD patients, leading to increased risk of malnutrition (Kigozi et al., 2021). Occupational Therapy practitioners play an important role in addressing these challenges. Through education, functional training, assistive device provision, and sensory interventions, OT practitioners empower caregivers and patients to navigate dietary management effectively. OTs can educate caregivers and patients about different dietary options and their effects on AD, thereby allowing for informed decision-making. Additionally, OT practitioners can develop personalized mealtime schedules and provide training in adaptive feeding techniques to enhance independence and reduce caregiver burden. Furthermore, OT practitioners can employ strategies such as errorless learning in Activities of Daily Living (ADL) training to maximize functional independence and ensure optimal nutrition intake.
Alzheimer's Disease (AD) is a formidable neurodegenerative condition characterized by the progressive deterioration of cognitive function, particularly memory and executive functions. Despite extensive research efforts, there is currently no cure for AD. According to Xu Lou et al. (2023), AD accounts for over 40-60% of all dementia cases worldwide, affecting more than 25 million people. With advancements in medical care leading to an aging population, the prevalence of AD is expected to rise significantly in the next two decades.
Research has suggested that diet can significantly influence the progression of AD in individuals with a mild to moderate diagnosis of the disease. Hence, exploring the effects of diet on AD becomes imperative. In this paper, I will elucidate the mechanisms contributing to the development of AD, discuss diets/habits with both negative and positive effects, explore the role of Occupational Therapy (OT) professionals in diet management and education, and pose the question: What Effect Does Diet Have on Alzheimer’s Disease?
At a biomechanical level, AD patients often exhibit common markers such as Amyloid-Beta Peptide accumulation in the brain, leading to plaque formation that disrupts neuronal signaling, and Tau protein tangles, which impede nutrient uptake in neurons. These processes ultimately result in neuronal dysfunction, contributing to memory loss, decreased executive function, and brain atrophy. Additionally, factors such as inflammation and vascular problems like diabetes and high blood pressure, alongside genetic predispositions such as APOE variants, play significant roles in AD development (National Institute of Aging, 2024; Leggett, 2022).
Dietary habits have emerged as crucial determinants of AD progression. While the Western diet, characterized by high fat content, refined grains, sugars, and cholesterol, exacerbates AB peptide accumulation and oxidative stress, healthier dietary patterns like the DASH and Mediterranean diets have been associated with reduced inflammation and AB peptide accumulation (Xu Lou et al., 2023). Moreover, ensuring adequate intake of essential nutrients such as Vitamin D, Omega-3 fatty acids, and Vitamin E has shown promise in alleviating AD symptoms (Ellouze, 2023).
However, maintaining a healthy diet can be challenging for individuals with AD due to various factors such as forgetfulness, difficulties in communication and swallowing, and caregiver-related challenges. Caregivers often struggle with proper nutrition knowledge and handling mealtime-related behaviors of AD patients, leading to increased risk of malnutrition (Kigozi et al., 2021).Occupational Therapists (OTs) play a pivotal role in addressing these challenges. Through education, functional training, assistive device provision, and sensory interventions, OTs empower caregivers and patients to navigate dietary management effectively. OTs can educate caregivers and patients about different dietary options and their effects on AD, thereby enabling informed decision-making. Additionally, OTs can develop personalized mealtime schedules and provide training in adaptive feeding techniques to enhance independence and reduce caregiver burden. Furthermore, OTs employ strategies such as errorless learning in Activities of Daily Living (ADL) training to maximize functional independence and ensure optimal nutrition intake (Xu Lou et al., 2023).
In conclusion, while there is no cure for AD, dietary interventions hold promise in delaying its progression and improving quality of life for affected individuals. By addressing dietary challenges through a multidisciplinary approach involving OTs, caregivers and patients there is evidence that can effectively manage AD-related nutritional issues and enhance overall well-being. While further research is needed to explore the intricate relationship between diet, genetics, and AD pathology, paving the way for more personalized and targeted interventions in the future there are many things that can be done now to improve the nutrition and quality of life in patients that have Alzheimer's Disease.
References
A rare mutation protects against Alzheimer’s disease, Stanford-led research finds. (2022, May 31). News Center. https://med.stanford.edu/news/all-news/2022/05/gene-mutation-alzheimers.html
Alzheimer’s Disease Genetics Fact Sheet. (n.d.). National Institute on Aging. https://www.nia.nih.gov/health/genetics-and-family-history/alzheimers-disease-genetics-fact-sheet
Claudino, P. A., Bueno, N. B., Piloneto, S., Halaiko, D. A., De Sousa, L. P. A., Maia, C., & Netto, B. D. M. (2024). Consumption of ultra-processed foods and risk for Alzheimer’s disease: a systematic review. Frontiers in Nutrition, 10. https://doi.org/10.3389/fnut.2023.1288749
Ellouze, I., Sheffler, J., Nagpal, R., & Arjmandi, B. H. (2023). Dietary Patterns and Alzheimer’s Disease: An updated review linking Nutrition to Neuroscience. Nutrients, 15(14), 3204. https://doi.org/10.3390/nu15143204
Kigozi, E., Egwela, C., Kamoga, L., Mbalinda, S. N., & Kaddumukasa, M. (2021). Nutrition Challenges of Patients with Alzheimer’s Disease and Related Dementias: A Qualitative Study from the Perspective of Caretakers in a Mental National Referral Hospital. Neuropsychiatric Disease and Treatment, Volume 17, 2473–2480. https://doi.org/10.2147/ndt.s325463
Lou, I. X., Ali, K., & Chen, Q. (2023). Effect of nutrition in Alzheimer’s disease: A systematic review. Frontiers in Neuroscience, 17. https://doi.org/10.3389/fnins.2023.1147177
Van De Rest, O., Berendsen, A. M., Haveman‐Nies, A., & De Groot, L. C. P. G. M. (2015). Dietary Patterns, Cognitive Decline, and Dementia: A Systematic review. Advances in Nutrition (Bethesda, Md. Print), 6(2), 154–168. https://doi.org/10.3945/an.114.007617
What happens to the brain in Alzheimer’s disease? (n.d.). National Institute on Aging. https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease