Enteral tube feeding for people with severe dementia

Abstract

Davies 2014Davies N, Maio L, Rait G, Ili e S. Quality end-of-life care for dementia: what have family carers told us so far? A narrative synthesis.

Reduced Pneumonia Risk in Advanced Dementia Patients on Careful Hand Feeding Compared With Nasogastric Tube Feeding

“…Prior research suggested that feeding tubes did not confer survival benefit, but the certainty of evidence was low because of risk of selection bias and limited controlling for confounders. 7,15 The current study found a lack of survival benefit with NGF compared with CHF and attempted to reduce risk of bias by selecting hospitalized patients with indication for tube feeding due to feeding problems and excluded patients with existing feeding tubes. We also controlled for a wide range of potential confounders through comprehensive review of hospital paper charts and the electronic medical record.…”

“…13,14 A recent Cochrane review found a high risk of bias due to confounding and selection bias among existing controlled, nonrandomized studies. 15 Critics challenged whether patients on tube feeding and those on oral feeding are comparable groups as the oral feeding patients may not have an indication for tube feeding. 14,15 Furthermore, the majority of studies were on percutaneous endoscopic gastrostomy (PEG) feeding or did not differentiate between nasogastric tube feeding (NGF) and PEG feeding.…”

“…15 Critics challenged whether patients on tube feeding and those on oral feeding are comparable groups as the oral feeding patients may not have an indication for tube feeding. 14,15 Furthermore, the majority of studies were on percutaneous endoscopic gastrostomy (PEG) feeding or did not differentiate between nasogastric tube feeding (NGF) and PEG feeding. 8,15 Two studies that focused on NGF showed mixed results on mortality risk.…”

“…14,15 Furthermore, the majority of studies were on percutaneous endoscopic gastrostomy (PEG) feeding or did not differentiate between nasogastric tube feeding (NGF) and PEG feeding. 8,15 Two studies that focused on NGF showed mixed results on mortality risk. 16,17 Additional studies on NGF are needed given this is the predominant type of enteral feeding used in people with dementia in many Asian countries including China, Taiwan, and Singapore.…”

Prevalence and Trends in Percutaneous Endoscopic Gastrostomy Placement: Results From a 10-Year, Nationwide Analysis

“…In the Japanese population, half of the patients who qualified for PEG were at least 80 years old ( 15 ). In a retrospective study on hospitalized patients, the number of PEGs in the elderly (more than 65 years) increased in the United States from 1993 to 2003 ( 33 ). However, more recent data presented decreasing trend in patients with neurodegenerative disorders ( 34 ).…”