title: Shift in diurnal feeding patterns in nursing home residents with Alzheimer's disease.
abstract: BACKGROUND
  Individuals with Alzheimer's disease (AD) are highly susceptible to weight loss and malnutrition, which, to date, have not been associated with decreased food consumption. The current study examined food intake patterns and how they change in relation to body mass index (BMI), behavioral function, and cognitive status in institutionalized seniors with AD.
  
  
  METHODS
  Twenty-one consecutive days of investigator-weighed food intake collections were conducted on 25 subjects with likely AD residing at a home for the aged. All subjects maintained the ability to self-feed.
  
  
  RESULTS
  Eighty-eight percent of participants did not meet targeted energy needs, including an estimated 37% prevalence of protein inadequacy. Subjects with increased behavioral difficulties, based on the London Psychogeriatric Rating Scale, had reduced meal-related intakes that were highly associated with decreased energy consumption at dinner. With behavioral changes, particularly increased mental disorganization and confusion, there was a shift in circadian eating patterns such that the greatest proportion of daily energy was consumed at breakfast. Individuals with low BMIs tended to be those with more behavioral difficulties, such that BMI was also associated with the shift in overall eating patterns.
  
  
  CONCLUSIONS
  Changes in behavioral function in seniors with AD result in a circadian shift in intake patterns with the preponderance of calories consumed at breakfast in those with increased behavioral difficulties. This shift in eating patterns associates both with poor overall intake and poor BMI.
authors.affiliation: Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada. karen.youjng@utoronto.ca
authors.forename: K W
authors.initials: KW
authors.lastname: Young
authors.forename: C E
authors.initials: CE
authors.lastname: Greenwood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology*; D001519:Behavior; D015992:Body Mass Index; D002940:Circadian Rhythm; D003071:Cognition; D004435:Eating; D002149:Energy Intake; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D009748:Nutrition Disorders / Q000209:etiology; D015431:Weight Loss