Case of Dementia in Which Dysgeusia and Anorexia Associated with Hypozincemia were Related to Apathy

Abstract

Background: In dementia, behavioral and psychological symptoms such as apathy and decreased a ppetite can markedly impair daily functioning. In older adults, dysgeusia and micronutrient deficien cies often coexist, evaluation from the perspective of nutritional psychiatry is clinically important.

Case: An elderly woman in her 80s with Alzheimer’s disease experienced worsening anorexia and loss of motivation following treatment for a urinary tract infection after a right pontine infarctio n. At presentation, her height was 145 cm, body weight 44 kg, body mass index 21, Mini-Mental State Examination score 5/30, serum albumin 2.8 g/dL, and serum zinc level 65 μg/dL, indicatin g hypozincemia. Anorexia associated with dysgeusia was suspected, and zinc supplementation at 150 mg/day was added in parallel with initiation of anti-dementia medication. Within two weeks, o ral intake improved from approximately 0–20% to nearly full meals, accompanied by recovery of vitality and facial expression.

Conclusion: When anorexia and apathy are observed in patients with dementia, assessment of dys geusia and nutritional markers such as serum zinc may be warranted, and interventions including z inc supplementation should be considered as part of nutritional psychiatry–based care.