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Journal of the American Geriatrics Society

Oral Feeding Options for People with Dementia: A Systematic Review

Authors

  • Laura C. Hanson MD, MPH,

    1. From the *Division of Geriatric Medicine, Center for Aging and Health, Cecil G. Sheps Center for Health Services Research, and Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and §School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
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  • Mary Ersek PhD, RN,

    1. From the *Division of Geriatric Medicine, Center for Aging and Health, Cecil G. Sheps Center for Health Services Research, and Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and §School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
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  • Robin Gilliam MSW,

    1. From the *Division of Geriatric Medicine, Center for Aging and Health, Cecil G. Sheps Center for Health Services Research, and Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and §School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
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  • Timothy S. Carey MD, MPH

    1. From the *Division of Geriatric Medicine, Center for Aging and Health, Cecil G. Sheps Center for Health Services Research, and Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and §School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
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Address correspondence to Laura C. Hanson, Division of Geriatric Medicine, Cecil B. Sheps Center for Health Services Research, CB 7550, University of North Carolina, Chapel Hill, NC 27599-7550. E-mail: lhanson@med.unc.edu

OBJECTIVES:

To review the benefits of oral feeding options in people with dementia.

DESIGN: Systematic literature search with review of potentially eligible studies by two independent investigators.

SETTING: PubMed/MEDLINE, EMBASE, the Cochrane Library, CINAHL, and PsychINFO literature indices between January 1990 and October 2009.

PARTICIPANTS: Clinical trials with random or nonrandom control groups were included if they reported on clinical outcomes of oral feeding interventions for people with dementia.

MEASUREMENTS: Investigators abstracted data from included studies using a structured instrument. Studies were graded on quality and potential bias, and overall strength of evidence was summarized.

RESULTS: Thirteen controlled trials provided data on use of supplements for people with dementia, and 12 controlled trials tested assisted feeding or other interventions. Studies provide moderate-strength evidence for high-calorie supplements, and low-strength evidence for appetite stimulants, assisted feeding, and modified foods to promote weight gain in people with dementia. The few studies measuring function or survival showed no difference.

CONCLUSION: High-calorie supplements and other oral feeding options can help people with dementia with feeding problems to gain weight; they are unlikely to improve other outcomes. These treatments can be offered alone or in combination as an alternative to tube feeding.

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