Problems with eating are usually a late sign of most dementias, although there are exceptions, as noted in the description of the typical stage of dementia in which eating problems occur. Problems commonly begin with inability to manipulate utensils, especially a knife. As the dementia becomes severe, there can also be problems with swallowing.
Commonly, when a person with dementia becomes ill, they will have problems with swallowing. These are often transient problems, and often go away as the acute illness is treated. In many hospitals, however, the transience of this problem is not recognized, and 'swallowing teams' are consulted. Often, after having carried out a swallowing assessment, they will order a pureed diet. Most hospital food is no treat, but a pureed diet could be used as a form of punishment in many parts of the world. The person is kept on it, at a great expense to quality of life, long after the danger of aspirating solid food has passed. Curiously, there is no reliable evidence that pureed diets achieve better outcomes than regular ones.
It is always worth remembering that lack of food intake can reflect a decreased appetite, which has many causes. An important - and often treatable - cause is depression .