Meal delivery practices, do not meet needs of Alzheimer patients with increased cognitive and behavioral difficulties in a long-term care facility

Background Alterations in circadian rhythms and behavioral difficulties lik ely impact meal consumption patterns in elderly individuals with probable A lzheimer's disease (AD). Despite these known changes, die profile of meals provided in the institution parallels the needs of younger, free-living, he althy populations. This investigation examined the impact of food delivery patterns on achieved intakes in elderly individuals with probable AD in a l ong-term care facility and how this relationship changes depending on time of day, body weight status, behavioral function, and cognitive ability. Methods. Twenty-one consecutive days of investigator-weighed food intake an d delivery collections were conducted on 25 elderly individuals with probab le A D who maintained the ability to self-feed. Results. Energy consumed was positively associated with energy delivered fo r the majority of subjects, although the strength of this relationship vari ed across subjects and throughout the day. Energy delivered had the greates t impact on energy consumed at breakfast and the least impact at dinner in those with the greatest behavioral difficulties and cognitive impairment. A lthough those with low body mass indexes (BMIs) were likely to be delivered more energy, the impact of delivery on intakes decreased as energy deliver ed increased. Conclusions. Delivering excess energy to, patients, with poor BMIs likely d oes not result in increased energy consumption. Behavioral and cognitive de terioration leads to a shift in the time of day that energy delivered has a n impact on energy consumption, with the most progressed individuals being most impacted by foods delivered in the morning, suggesting that traditiona l meal practices are inappropriate for elderly individuals with AD.