Practice Consideration
Cognitive function may be viewed as a spectrum ranging from normal cognitive functioning to dementia.(1) Cognition refers to the act of processing and manipulation of information. It includes processes such as awareness, perception, learning,memory, and reasoning.(1,2,3) Mild impairment is a transitional stage and does not normally impact quality of life or threaten independence. In some instances, memory loss will result in either eating more often than usual or forgetting to eat at all. However more severe declines are associated with loss of functional abilities including eating, swallowing and chewing.(4,5,6) The prevalance of swallowing difficulties in individuals with dementia range from 13% to 57%.(4) With cognitive decline, residents also have difficulty with the eating process. Eating, chewing and swallowing is a complex process and is often difficult for persons as dementia progresses.
References:
1. Alish, C. The Connection Between Malnutrition and Cognitive Decine in Older Adults. 2015. Accessed October 2, 2020. Available at: https://anhi.org/resources/articles-and-briefs/cognition-aging-and-nutrition.
2. Horning S, Davis HP. Aging and Cognition. 2012:44-52.
3. Chodosh J, Seeman TE, Keeler E, et al. Cognitive decline in high-functioning older persons is associated with an increased risk of hospitalization. J.Am.Geriatr.Soc. 9/2004 2004;52(9):1456-1462.
4. Petersen RC. Clinical practice. Mild cognitive impairment. N.Engl.J.Med. 6/9/2011 2011;364(23):2227-2234.
5. Bynum JP, Rabins PV, Weller W, Niefeld M, Anderson GF, Wu AW. The relationship between a dementia diagnosis, chronic illness, medicare expenditures, and hospital use. J.Am.Geriatr.Soc. 2/2004 2004;52(2):187-194.
6. Gussekloo J, Westendorp RG, Remarque EJ, Lagaay AM, Heeren TJ, Knook DL. Impact of mild cognitive impairment on survival in very elderly people: cohort study. BMJ. 10/25/1997 1997;315(7115):1053-1054.
7. Alagiakrishnan K, Bhanji RA, Kurian M. Evaluation and management of oropharyngeal dysphagia in different types of dementia: a systematic review. Arch Gerontol Geriatr. 2013 Jan-Feb;56(1):1-9. doi: 10.1016/j.archger.2012.04.011. Epub 2012 May 19. PMID: 22608838.