Dementia often leads to **strange cravings or aversions** because the disease affects the brain areas responsible for appetite, taste perception, memory, and emotional responses related to food. These changes can cause people with dementia to suddenly desire foods they never liked before or reject foods they once enjoyed, sometimes in puzzling or unexpected ways.
One key reason is that dementia can cause **”time-shifting,”** where a person believes they are living in an earlier period of their life. This mental confusion can lead them to crave foods typical of that past era or their younger years, even if those foods don’t fit their current lifestyle or dietary habits. For example, a lifelong vegetarian might suddenly want to eat meat because their brain is recalling a time before they adopted vegetarianism. Similarly, someone who avoided certain foods for religious reasons might start craving those forbidden items because their current sense of identity and rules has become blurred[1].
The brain regions that regulate hunger and satiety, such as the hypothalamus, can be damaged by dementia, disrupting normal signals about when and what to eat. This can lead to **increased or decreased appetite** and unusual food preferences. Additionally, dementia can impair the sense of taste and smell, which are crucial for food enjoyment and selection. When these senses decline, people might seek out stronger flavors, like very sweet or very salty foods, or reject foods that taste bland or unfamiliar. This sensory change can explain why some people with dementia develop cravings for sweets or show aversions to previously liked foods[4].
Another factor is the **loss of recognition and understanding**. As dementia progresses, individuals may no longer recognize certain foods or understand their purpose. This can cause them to put non-food items in their mouths, mistaking them for edible things, or to avoid foods because they don’t recognize them as safe or familiar. This behavior is not uncommon and reflects the brain’s difficulty in processing sensory information and memory[1].
The **gut-brain axis** also plays a role. The gut microbiome influences brain function through neurochemical production, including serotonin, which affects mood and appetite. Dementia and aging can disrupt gut health, leading to changes in mood and cravings. Poor gut health or inflammation may increase cravings for processed or sugary foods that stimulate brain pleasure centers, even though these foods might worsen overall health. Conversely, a disrupted gut-brain connection can cause aversions or reduced appetite due to discomfort or digestive issues[3].
Emotional and psychological factors contribute as well. Dementia can cause anxiety, confusion, and distress, which may manifest as changes in eating behavior. For example, some people might crave comfort foods that provide a sense of security or familiarity, while others might develop aversions due to negative associations or sensory overload. Anxiety after eating, which can be linked to physical reactions like reactive hypoglycemia or food sensitivities, might also influence food preferences and avoidance behaviors[2].
Medication side effects and physical health changes common in dementia can alter taste, appetite, and digestion, further complicating eating habits. Some medications can dull taste buds or cause nausea, leading to food aversions. Digestive changes might make certain foods harder to tolerate, prompting cravings for softer or easier-to-digest options[1].
In some cases, dementia can cause obsessive behaviors, including fixation on certain foods or eating patterns. This can result in repetitive cravings or refusal to eat anything but a narrow range of foods. These behaviors reflect the brain’s impaired ability to regulate impulses and adapt to changing needs[4].
Alcohol use in people with dementia can also affect cravings and aversions. Alcohol can increase confusion and dehydration, and some individuals might drink excessively because they forget how much they have consumed. Others might crave alcohol due to past habits or dependency, complicating their nutritional status and overall health[5].
Overall, the strange cravings and aversions seen in dementia arise from a complex interplay of brain changes affecting memory, sensory perception, emotiona
