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The Calming Effect of Chocolate in Late Stage Alzheimer's

 Chocolates

The Medical Director’s Association (AMDA) publication “Caring for the Ages” for February 2011 contains a most interesting article on Chocolate and Alzheimer’s. The article is by Dr. Jeffrey Nichols and is entitled: “The Allure – and Importance – of Chocolate”. This article in turn references a story in the New York Times of 31 December 2010 headlined: “Giving Alzheimer’s Patients Their Way – Even Chocolate.

This article describes a nurse in the Beatitudes Nursing Home in Phoenix, AZ. This account tells of a nurse who “was reported to carry chocolate in her pocket to give residents who were agitated.”  It also described a case history of “one resident whose behavior and general well-being seemed to benefit”.

Dr. Nichols then describes a significant body of scientific literature on the topic of chocolate and Alzheimer’s disease. “Chocolate contains caffeine, which in turn is a neurostimulant that has been shown to increase neurotransmitter levels, including those of acetylcholine, and to improve memory and executive function. Dark chocolate contains much larger quantities of the obromine and other methylxanthines that lower blood pressure and might inhibit beta-secretase. That’s the enzyme that produces the beta-amyloid in the brain plaques that characterize Alzheimer’s disease. Chocolate also contains substantial quantities of flavonoids. These antioxidants have been shown in a peer reviewed article to improve function in Alzheimer’s model mice”.

Agitated behaviors in dementia are generally “about” something rather than simply a behavioral manifestation of that disease. To the extent that we can identify what a patient wants and needs we can modify his or her behaviors. It might not be clear whether the resident was simply hungry, a lifelong chocoholic needing a fix, or simply feeling neglected or lonely, and so responding to the pleasant flavor and underlying psychological association that food is love. What is clear is that the chocolate was being used as an element of the nonpharmacologic modalities that often are effective in this setting….”

“Perhaps the bottom line here is that we need to look at our residents not just as patients, but as people. If the adorable 3-year old in you life lights up at the  sight of a chocolate chip cookie and finishes his dinner with alacrity, why not the adorable (or even not so adorable) 90 year old dementia patient? The real excitement in the chocolate story was the possibility that even with advanced age and frailty there still can be joy.”

I would change the doctor's last statement to read: “The real excitement in the chocolate story is the possibility that even with advanced Alzheimer’s there may be moments of joy.

June loved chocolates. However at the time June was in a nursing home in her late stages of Alzheimer's, chocolate was the last thing on my mind as an item for her diet. I regret that this information concerning chocolate was not a part of my knowledge during those bleak days. Perhaps it might have brightened her days just a little bit. Of course in the very late stages when her food was pureed, it might have been more difficult to utilize.

The below photo of June was taken in November 2005 during her birthday celebration at the Wellstead of Rogers, an Alzheimer's facility. June first arrived at the Wellstead on March 16th, 2005. It was four months later than the November photo (March 2006) that June's food requirements were such that her food was to be pureed to resist choking or swallowing difficulties. In this November 2005 photo, June's usual million dollar signature smile is weak and her face has a faded look. I find it hard to look at this picture of June without getting a lump in my throat!

 June Berg 2005 at Wellstead

After battling Alzheimer's for almost 11 years, an exhausted June was called home by God on October 23rd, 2008. Her funeral notice as published in the Minneapolis Star in October 2008 can be seen on this website under the "In Memoriam" label -   Click on:

"June K. (Rolstad) Berg - In Memoriam".