Feeding difficulty in dementia

Roger Watson

What is dementia?

• Various brain disorders that have, in common, loss of brain function which is progressive and, eventually, severe.

• How many people have dementia?– 750,000 in UK (population 50 million)– 353,800 in Australia (population 24million)

What causes dementia?

· Genetics· Co-morbidity· Lifestyle· Infection· Old age?: 40-65 1 in 1000

65+ 1 in 5070+ 1 in 2080+ 1 in 590+ 1 in 2

• At present there is no ‘cure’ for dementia

What happens to someone with dementia?

• Progressive cognitive decline:· loss of memory· subtle changes in personality

• Behavioural change:· wandering· aggression· incontinence· problems with eating

Food and dementia

• Almost inevitable disturbances to eating in dementia with decline in eating towards the terminal stages

• Weight loss is also associated with dementia but this may not just be the result of eating difficulty

• In fact, it has been demonstrated that weight loss can precede the onset of dementia

Records identified = 353

Remaining after duplicates removed and

papers screened = 13

Discarded =

340

Qualitative synthesis = 13

Meta-analysis = 0

Conclusions

• General methodological weakness:• Small samples (type II error)• Confounding variables• Impossibility of ‘blinding’ participants

• ‘Bottom drawer’ phenomenon

• How do we know what is clinically significant?

Montessori and spaced-retrieval methods

Maria Montessori

• Spaced retrieval, also known as expanded retrieval or uniform retrieval, is a learning technique, which requires users to rehearse information to be learned at different and increasing spaced intervals of time or a set uniform amount of time.

Montessori and spaced-retrieval methods

• Procedural memory is a part of the long-term memory that is responsible for knowing how to do things, also known as motor skills. As the name implies, procedural memory stores information on how to perform certain procedures, such as walking, talking and riding a bike.

r.watson@hull.ac.uk

0000-0001-8040-7625

@rwatson1955