Natural history of hyperphagia and other eating changes in dementia.
OBJECTIVE
To investigate the natural history of overeating (hyperphagia) and its elements during the course of dementia.


METHODS
Prospective longitudinal study of overeating (hyperphagia) in dementia. Two studies were carried out: (1) hyperphagia and associated eating changes were investigated as part of a larger prospective 10-year study into behaviour changes, using carers' reports; (2) an observational study to investigate hyperphagia quantitatively; this took place over the course of a year by means of direct observation of test meals in a normal environment.


METHODS
Subjects with dementia living in Oxfordshire, UK.


METHODS
(1) 99 people with dementia, living at home with a carer, with data for more than 1 year. (2) Nine people with a diagnosis of Alzheimer's disease who were hyperphagic.


METHODS
(1) The Present Behavioural Examination was used at 4-monthly intervals to assess the subjects' behaviour and psychological functioning. (2) Food intake, macronutrient choice and the microstructure of eating were measured using a standardized test meal.


RESULTS
(1) Severe or persistent hyperphagia was reported in 23% of the sample and carers reported a clear onset to hyperphagia with a median duration of 16 months. (2) From direct observation, each person who was hyperphagic was seen to maintain a constant eating rate in test meals during the course of a year but meals ended earlier as hyperphagia decreased.


CONCLUSIONS
Hyperphagia is common in dementia, it occurs over a single restricted period, mainly during the middle stages of dementia, and is not significantly related to age, sex, diagnosis, medication or activity.
Keene
J
J
Department of Psychiatry, University of Oxford, UK.
Hope
T
T
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003704:Dementia / Q000150:complications / Q000523:psychology*; D018450:Disease Progression; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D006963:Hyperphagia / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013997:Time Factors