Aspiration risk becomes a serious problem in advanced dementia. It happens when food, liquids, or saliva go into the lungs instead of the stomach, often leading to pneumonia.
In the later stages of dementia, the brain loses control over swallowing and breathing. Normally, these actions work together smoothly. But as dementia worsens, people struggle to coordinate them. This lets bits of food or drink slip down the wrong way into the lungs. The result is aspiration pneumonia, which is the top cause of death for those with advanced dementia.[1][5]
Silent aspiration is common too. This means it happens without coughing or choking, so caregivers might not notice right away. Studies on Alzheimer’s disease, a main type of dementia, show reduced feeling in the throat and weaker muscles there. These changes raise the chance of quiet aspiration and lung infections.[2]
Swallowing problems, called dysphagia, affect 13 to 57 percent of dementia patients, especially late in the disease. It makes eating hard and cuts down on nutrition. People may choke, cough a lot at meals, or lose weight quickly.[4][7][9]
Weak immune systems and less movement make infections worse. Lying down more leads to shallow breathing and more risk. Signs include fever, sudden confusion, wet coughs, or trouble breathing.[1][5]
Feeding tubes do not fix this. They aim to avoid pneumonia from mouth secretions or stomach contents coming up, but studies show no drop in risk. Oral care stays key, and tubes can still lead to issues.[4]
Caregivers can help by watching meals closely. Sit people upright, offer small bites of soft foods, and go slow. Thickened drinks cut liquid risks. Spotting early signs like frequent coughing helps get support fast.[7]
In end stages, the brain fails on basics like breathing patterns and body temperature. Aspiration adds to this decline, but comfort care focuses on easing symptoms over aggressive fixes.[1]
Sources
https://myhometouch.com/articles/how-does-a-person-die-from-dementia
https://onlinelibrary.wiley.com/doi/10.1002/lary.70264?af=R
https://en.wikipedia.org/wiki/Alzheimer%27s_disease
https://www.hmpgloballearningnetwork.com/site/altc/article/3310
https://www.amboss.com/us/knowledge/alzheimer-disease/
https://www.consultant360.com/articles/foreign-body-aspiration-guide-early-detection-optimal-therapy-1
https://anvoihealth.com/hospice-for-dementia
https://www.eldac.com.au/Our-Toolkits/Dementia/Clinical-Care/Respond-to-Deterioration
https://www.droracle.ai/articles/618498/what-causes-decreased-oral-intake-in-the-elderly
