Importance of Feeding for Sick People: Nutrition and Hydration Practices
March 31, 2016
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Nutrition and Hydration needs of older people with dementia – Evidenced Based Research: Must Read guidelines for Dietitians and Nurses practiced in Indian care

In India, around 3.7 million people are affected with dementia (loss of or decline in memory and other cognitive abilities) which approximately costs around 14,700 crores . However, it is projected to increase two-fold by 2030 while three-fold by 2050 due to steady growth in the Indian older population and stable increment in life expectancy. Although the still there is a lack of clear consensus on the diagnosis of dementia, two main types of criteria are commonly used for diagnosis dementia that includes the DSM-IV criteria developed by American Psychiatric Association (The diagnostics and statistical Manual for mental disorders, Fourth Edition ) and the 10/66 dementia diagnosis.

Since these tools are developed considering the Western scenario, its applicability in terms of the validity and reliability of Indian condition are less studied. However, the good news is that these conditions are modifiable with proper nutrition, diet and hydration practices apart from other factors such as alcohol, obesity, smoking, and controlling other co-morbidities.

The disappointing results from preventive intervention trials to date are very little understanding of nutrition and dietetics practices in India linked to dementia. This may be perhaps due to the lower prevalence and incidence in these setting. However, it’s time to act rather than wait for studies from Indian aspects. Since diagnostic criteria’s are adopted from the Western continent; it would be wise to adopt successful intervention therapies /models to treat these people who need immediate care until we develop the one that suits our Indian population.

Nutrition Principles

  • Weight Loss at all stages but greater impairment of the BMI and brachial fatty and lean mass in the advanced age
    a.Recommendations Nutrition Principles:

    • i.Objective Evaluation:
    • ii.Anthropometry
    • iii.the evaluation of clinical signs of malnutrition,
    • iv.evaluation of food intake,
    • v.the subjective Mini Nutritional Assessment (MNA) – To identify the risk of malnutrition in the elderly
    • vi.The Nutrition Screening Initiative – Self applied questionnaire
    • vii.Output tests: Lymphocytes, albumin, blood cholesterol, hemoglobin, and transferring
  • Nutrition and Hydration Practices in Severe dementia: Results of evidence-based studies
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