Im Verlauf von Demenzerkrankungen treten Ernährungsprobleme auf, die mit Reduktion
der Essmenge und erhöhtem Mangelernährungsrisiko verbunden sind. In der vorliegenden
Arbeit wird der Zusammenhang zwischen Ernährung und Demenz beleuchtet und beschrieben,
welche Maßnahmen sinnvoll sind, um einen guten Ernährungszustand möglichst lange aufrechtzuerhalten
und so zum Erhalt von Gesundheit, Funktionalität und Selbstständigkeit beizutragen.
Abstract
Nutrition and cognitive health mutually influence each other and are both important
for the maintenance of independence and wellbeing up to old age. It is the aim of
the present review to summarize the state of knowledge regarding the relation between
nutrition and dementia and to highlight effective interventions to maintain adequate
nutrition as long as possible.
Various food components are known to be important for brain structure and functioning
and related to cognitive performance. In epidemiological studies protective effects
of adherence to a traditional Mediterranean diet on cognitive health are described.
In the course of dementia sooner or later nutritional prolems appear which mostly
lead to unbalanced and insufficient nutrition. Thus, nutritional interventions should
be a fixed component of dementia treatment. They should be based on a routine screening
for malnutrition, followed by assessment when appropriate, and periodic body weight
control in order to recognize problems early. In all stages of dementia, an adequate
oral nutrition can be supported by attractive, high-quality food according to individual
preferences and needs served in a pleasant ambience, by adequate nursing support and
treatment of underlying causes of malnutrition. If nutritional requirements are not
met by usual food, oral nutritional supplements are recommended in order to improve
nutritional status. Beneficial effects of energy and/or nutrient supplementation on
cognitive abilities are however not proven. Artificial nutrition is only rarely indicated.
In each case individual benefits and risks should be carfully weighed and the patients
(presumed) will considered. In patients with advanced dementia and in the terminal
phase of life artificial nutrition is not recommended.
Schlüsselwörter
Demenz - Ernährung - Mangelernährung - Ernährungsmaßnahmen - Sondenernährung
Keywords
dementia - nutrition - malnutrition - nutritional intervention - tube feeding
