Over six million people in the U.S. live with dementia. By 2050, that number is expected to double.
Yet, even so, the signs of cognitive decline can be difficult to spot.
Alzheimer’s disease is the most common cause of dementia, Majid Fotuhi, an adjunct professor at Johns Hopkins University, told Inc. It typically begins by attacking the brain’s memory center. As a result, short-term memory loss, repeating questions, and getting lost in familiar places tend to be the earliest signs of dementia.
While about one in every three people over the age of 85 will be diagnosed with Alzheimer’s disease, it is not the only form of dementia.
Frontotemporal dementia, commonly referred to as FTD, attacks the frontal and temporal lobes first. These are the areas of the brain responsible for judgment, social behavior, and impulse control. With this type of disease, the memory is still fully intact, Fotuhi said.
However, unlike Alzheimer’s, one early hallmark of FTD is changes in eating behavior—especially sudden sweet cravings, overeating, and eating the same foods over and over.
What eating changes signal early warning signs of dementia?
Fotuhi told Inc. that the changes worth paying attention to are less about what someone is eating and more so about how they are eating. Patterns and relationships shifting, like someone craving dessert when they never had a sweet tooth before or overeating without registering fullness, are some hallmarks of this behavior.
“What makes these signs meaningful is that they represent a break from a longstanding pattern, not a one-time craving or a phase,” Fotuhi said.
Adam S. Mednick, a neurologist at the Regional Brain Institute, agreed. He told Inc. that new cravings for sweets or carbohydrates can be an early warning sign of dementia, in addition to a shift in food preferences, rigid new eating rituals, increased appetite, fast or messy eating, unexplained weight loss, reduced smell and taste, and forgetting meals.
“Food and eating changes are more prominent and appear earlier in frontotemporal dementia, while memory problems dominate early Alzheimer’s,” Mednick told Inc.
Additionally, a new and persistent loss of table manners or social awareness around food are the changes that Fotuhi takes most seriously. “This includes things like eating off other people’s plates, eating compulsively, losing the sense of when a meal is finished, or a marked change in food preference paired with a blunted emotional response to things that used to matter to that person,” he told Inc.
Which of those changes most reliably warrants cognitive screening?
Fotuhi said that since FTD does not start in the hippocampus, memory “can stay intact even as the frontal lobe circuits that govern impulse control, reward, and social judgment around food start to misfire.”
The area of the brain that is experiencing damage is the same one responsible for cravings and restraint, which is why these changes in eating may signal a larger underlying issue.
Additionally, a personality change that manifests through blunted empathy, social withdrawal, or loss of a usual filter in conversation—particularly when it appears in tandem with changes in eating behavior—should be addressed.
“Families often explain these shifts away as someone ‘mellowing with age’ or ‘just being set in their ways,’” Fotuhi said. “But a genuine rapid change in who a person is, not just what they remember, deserves attention.”
—Lucia Auerbach
This article originally appeared on Fast Company’s sister website, Inc.com.
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