What’s anemia got to do with dementia?




A new study finds evidence that having anemia increases your risk for dementia.


As a part of healthy aging, we ought to care for our bodies as much as we care for our brain. There is a BIG connection between the two that we’re learning more about everyday.

Just this week I read some new research, which suggests that having anemia today might increase your risk for developing dementia in the future.  The study is called the Health, Aging and Body Composition study and it followed 2,552 men and women in their 70s for 11 years. Over this time, researchers found that the people who had anemia were more than 40% likely to have dementia over that 11-years compared to people who did not have anemia1.

But how do we know that anemia is directly causing the dementia? After all, dementia has many causes and risk factors like genetics, obesity, drug abuse, etc.  The truth is we don’t know for certain that anemia directly causes dementia. In the study, researchers did consider these other risk factors but still found anemia to be an “independent risk factor.” This means that even if anemia is your only risk factor for dementia you are more likely to get dementia than if you did not have anemia.

Anemia in older adults is pretty common and increases with age: someone who is 65-74 years old has an 8% of getting anemia but this quickly rises to 20% when they hit 852. Researchers acknowledge that it is not known if treating anemia will prevent dementia. But if you ask me, it certainly wouldn’t hurt!

It is safe to say that both you and I would rather not live with anemia or dementia. Just because we’re aging does not mean we should accept a lower quality of life. While some types of anemia cannot be prevented others can be.

Many types of nutrition-related anemias can be prevented eating a diet rich in iron, B12, folate and vitamin C. Here’s what you can add to your future shopping list3:

  • o Meats like beef, pork and chicken  (iron, B12)
  • o Beans and lentils (iron, folate)
  • o Breads and pastas (folate)
  • o Milk and cheeses (B12)
  • o Eggs (B12)
  • o Oranges, lemons, grapefruits (folate, vitamin C)
  • o Kale, collards, spinach and other dark leafy greens (folate, iron)
  • o Melons and berries (Vitamin C)

iron b12 folate foods







  1. http://www.agoritsaslaw.com/wp-content/uploads/2013/08/Anemia.jpg
  2. http://700childrens.nationwidechildrens.org/wp-content/uploads/2013/10/anemia-770×420.jpg



  1. 1.    http://www.alzinfo.org/03/articles/diagnosis-and-causes/anemia-tied-dementia-risk
  2. 2.    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572827/
  3. 3.    http://www.mayoclinic.org/diseases-conditions/anemia/basics/prevention/con-20026209

Colored Plates: What do Fiestaware and Dementia Have in Common?

Got Fiestaware?  My mom does…she has a whole set of plates and bowls in lots of vibrant, beautiful colors.  Having a meal on a colored plate just seems to make mealtime more fun!

I recently read a great post from The Alzheimer’s Reading Room discussing the use of colored plates in Alzheimer’s patients.  (FYI: The Alzheimer’s Reading Room is a great resource for those with or caregiving for someone with Alzheimer’s.  They have great resources and an active community for you to connect with.  I highly recommend them!!)

The post mentions that colored plates help Alzheimer’s patients see their food more clearly, which as you can imagine, seems to help with intake.   This isn’t a new phenomenom but one we’ve been using in the practice of dietetics for some time.  Colored plates help those with visual impairment see contrast and therefore enhance intake.  Our brains also seem to pick up on the colors and may influence us to eat differently.  In particularly, red plates do seem to increase intake.

So to answer the original question…what do Fiestaware and dementia have in common?  That colorful Fiestaware (or a colored disposable plate) could be an easy trick to helping your loved one with or without dementia eat more!

Have a great weekend!  Sunday is Grandparent’s Day…be sure to honor and/or remember your grandparents!!



1.  The Alzheimer’s Reading Room:  http://www.alzheimersreadingroom.com/2011/11/thanksgiving-postscript-wont-eat-didnt.html#more

2.  Photo:  Kenan Crawford Hill

Increasing Appetite: New Ideas

Many of us working in older adult nutrition often work with clients who complain of poor appetite.  This isn’t surprising since we now know that as we age our hormonal regulation of appetite is altered.  Hormonal changes coupled with changes in the GI tract (early satiety, constipation and  changes in smell and taste, etc.) can make feeding drive reduced.

Dietitians have tackled this issue creatively.  We’ve worked with clients on meal timing, food texture, meal preparation, the food environment and if required, used appetite stimulants.  Many of us have found that having appealing food smells wafting through the air can be just as successful as some appetite stimulants.  For example, baking bread prior to meal time seems to increase appetite when the meal is served.

I was so pleased to see this idea translated into practice during the UK’s Design Council Challenge.  If you haven’t heard, the UK Design Council partnered with the Department of Health to fund five innovative new design solutions to improve the quality of life for people living with dementia.

The design solutions are brilliant!! My favorite, the group focused on weight loss and poor appetite. Their solution, ODE, a small, discreet device that reminds people to eat and stimulates appetite by releasing pleasant food odors into the home. Magnificent!!

Here is the video that explains the device:


I’m so glad to see the UK taking a lead on thinking “outside the box” on issues around aging and dementia and for remembering that malnutrition and aging is just as important as obesity management.  Well done!

Coconut, Dementia and Aging: Part 2

A few weeks ago I posted about coconut oil and the aging brain. If you do decide to try this with your older adult, here are some ins and outs on the use of coconut oil.

Coconut oil can be used to replace many cooking oils and is even safe for frying and baking. It is a solid at room temperature, but melts very easily. Some people will prefer to simply use coconut oil where they are already using other cooking oils, but what about the most effective dose for dementia patients?

For that we look to Axona, the FDA-approved medical food mentioned in the March 22 post. In total, each day’s worth of Axona contains 20 grams of medium chain triglycerides (MCT). Fast-forward through the math and that translates to 7 teaspoons per day of pure coconut oil to get the same amount of MCT. As with any oil, this is going to contribute about 275 calories and 32 grams of fat to the diet. Unlike many cooking oils, most of this fat is saturated.

If this regimen helps your older adult, the first signs of improvement will take weeks to months to appear and continual use of coconut oil will be necessary to sustain the benefits. With all of this coconut oil consumption, you might need to stock up. One of my students, who is an avid fan of coconut oil, suggested Spectrum and Nutiva if you’re looking in stores and Tropical Traditions if you prefer to shop online or buy in bulk.

As always, I would encourage you to talk with your physician or your registered dietitian about this before you begin.

Guest Blogger:  Hannah Martin


Image:  http://www.google.com/imgres?q=7+teaspoons&hl=en&client=safari&rls=en&biw=1738&bih=960&tbm=isch&tbnid=-BognOIG-bjCOM:&imgrefurl=http://www.tias.com/13609/PictPage/3923875153.html&docid=Msx8qqCQuXpWjM&itg=1&imgurl=http://www.tias.com/stores/hollylane/pictures/cc8182a.jpg&w=299&h=287&ei=iVqRT_6iEo-I6AG4lI2sBA&zoom=1&iact=hc&vpx=1318&vpy=606&dur=339&hovh=220&hovw=229&tx=158&ty=126&sig=112940717231066151774&page=1&tbnh=139&tbnw=147&start=0&ndsp=43&ved=1t:429,r:32,s:0,i:139


Coconut Oil, Dementia and Aging: Part 1

Do you drink coconut water?  Do you cook with coconut oil?  What are the benefits of each? I’ve been getting a lot of questions about coconut and health.  I thought it might be time to bring it up here.

First, let’s have a quick lesson on coconut and it’s components.  Coconut oil is the oil that is withdrawn from the meat of matured coconuts.  Coconut water is the liquid inside the coconut that has a milky looking consistency.  Coconut oil is of interest to many because it holds up well at very high temperatures (especially during frying) which is due to its high saturated fat content  (something that isn’t that great for your heart).  Coconut water has peaked in popularity because it is a natural source of electrolytes, like that found in many popular sports drinks.

Recently, there has been more and more in the press about the benefits of coconut oil for patients with dementia.  I know many of you may have watched this video on YouTube:

This video has also been on Twitter and is under discussion in support groups.

The component of coconut oil that is of interest is MCT.  MCT’s or Medium Chain Triglycerides are commonly used in dietetic practice as a type of replacement fat for clients experiencing fat malabsorption or having lots of GI distress after eating fatty foods.  They are helpful because they do not require bile acids for digestion.

MCTs may also help with managing some forms of dementia.  Why is this?  Well, the brain uses two types of fuel:  1.  glucose and 2.  ketones.  Glucose, which comes from the breakdown of carbohydrates, is the brain’s preferred source of fuel or energy.  As we age and cognitive decline sets in, the brain doesn’t use glucose quite as well.  The aging, cognitively impaired brain seems to continue to use ketones well, if available.  Ketones come from the breakdown of body fat and/or from including MCTs in the diet.

The big questions is:  Does the aging brain, in someone with dementia, work better on ketones?

One of the speediest ways to get ketones to the brain is to increase the number of MCTs in your diet.  Coconut oil is made up of ~50-60% of MCTs.  Other sources of MCTs are Axona (~50% MCT), a medical food, or  straight MCT oil (100% MCT).

Some patients, with some forms of dementia, have seen mild improvements in their memory and in performing simple tasks when increasing the amount of MCT in their diet.

Is coconut oil safe? Want to know how much to add?  For how long? AND What type of coconut oil to use?  Be sure to re-visit the blog next week as our discussion continues…

Who Inspired Me?

I recently received an email asking why I blogged about older adult health and nutrition.  The answer, of course, was clear to me but something that I hadn’t shared with many of you.  So here goes…

My childhood was blessed by wonderful relationships with two parents and three grandparents.  I spent lots of time in the summer at my grandparents playing and EATING!  Many of my memories are revolve around food, food preparation and meal time.

Ginger ale floats, fruit pies, fresh picked berries, chicken salad, sweet corn on the cob, dinner rolls, biscuits, cinnamon toast, BLTs, spaghetti, oyster stew and red hot dogs are just a few of the foods that conjure up the best of memories. These memories are not only about food but about the hands that prepared them…the same hands that gave me endless hugs, wiped away tears, played card games, sewed Easter dresses and helped me catch baby frogs.

My mother’s parents are gone now, but their memories are still with me.   My Grandpa let me ride his tractor, taught be about gardening and being kind to animals.  My Grandma taught me patience and love.  I will forever remember trips to the local nursing home with my Grandma Josephine. These visits laid the foundation for my interest in healthcare and aging.

My father’s mother was young and active when I was small. Grandma C is my father’s mother and she helped me become interested in health and nutrition.

Amanda and Grandma C










She was the best cook!  If she touched it I knew it was going to be delicious!!  She was a home extension agent (the earliest type of dietitian) and often told me about the health benefits of food.

Amanda and Grandma C (1980s)








Her aging and healthcare journey have helped me realize the lack of resources around aging and nutrition.  A stroke in the summer of 2009 left significant damage in her brain. Her dementia can make the days long and the visits sometimes difficult but we are lucky (and thankful) that she didn’t lose her beautiful smile, her feistiness and love for her family (and butter pecan ice cream).

Amanda and Granmda C (Now)








My hope is that through this blog – and Twitter- we can connect you to nutrition knowledge that will make your life healthier and more successful.

Food for Thought: Tips for Eating with Dementia

Food for Thought: Tips for Eating with Dementia

Food is somewhat of a driving factor in our society. People work hard all day long just to put food on the table; when things go wrong in life or if someone has had a bad day, there’s comfort food for that. According to “Dementia Care Central,” for people with dementia, sitting down to eat a meal can turn into quite the frustrating ordeal, especially when dealing with declines in both mobility and memory capability. Eating is supposed to be enjoyable, but for people with dementia, it can be more of a stressor than anything else. Here are a few tips for a better dining experience for people with dementia:

  • Comfort is Key

Never let the person eat alone because having someone there means someone cares, and if someone cares, then they are prone to eat more. If there is too much noise or activity in the dining area, the person with dementia could find it difficult or upsetting to concentrate on eating. A calm environment will help the person feel at ease and comfortable in their surroundings.

  • The Simpler, the Better

Having too many food options could frustrate the person and make the experience more stressful. A meal could take up to an hour to eat, so the more food, the more time needed at the table.

  • A Helping Hand

Sometimes people with dementia may need a little refresher course on how to use a knife or fork by demonstrating how to cut up meat or spread butter on bread. But don’t baby them, they still need to be respected and made to feel like they are independent.

  • Encourage easier eating

Cut up the food in bite sized pieces or prepare soft, pureed, or finger foods to aid ineasy eating. Don’t overlook proper fluid intake either- lids and straws help with the drinking process as well.

Helpful Resources:  http://www.alz.org/living_with_alzheimers_eating.asp

Guest Blogger:  Lisa Hopkins