Insufficient evidence for benefit of enteral tube feeding for older people with advanced dementia

January 01, 0001

Insufficient evidence for benefit of enteral tube feeding for older people with advanced dementia

Clinical Question:How effective is enteral tube feeding for older people with advanced dementia?

Bottom line: Despite the large number of patients receiving this intervention, there is insufficient evidence for the effectiveness of enteral tube feeding for older people with advanced dementia in terms of survival, quality of life, nutrition and pressure ulcers, function and behavioural or psychiatric symptoms of dementia. Data are lacking on the adverse effects of this intervention.

Caveat: No information about short-term toxicity from radiotherapy or quality of life data was reported. Clinicians therefore need to ensure that comprehensive information relating to potential side effects is made available to women undergoing this treatment.

Context: The use of enteral tube feeding for patients with advanced dementia who have poor nutritional intake is common. In one US survey, 34% of 186,835 nursing home residents with advanced cognitive impairment were tube fed. Two methods of enteral tube feeding are commonly used: the administration of food and fluids via a nasogastric tube or via a percutaneous endoscopic gastrostomy (PEG). Potential benefits or harms of this practice are unclear.

Cochrane Systematic Review: Sampson EL et al. Enteral tube feeding for older people with advanced dementia. Cochrane Reviews 2009, Issue 2. Article No. CD007209. DOI:10.1002/14651858.CD007209.pub2. This review contains 7 studies involving 1821 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 190, August 2009.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: D. Digestive, N. Neurological. Keywords: enteral tube feeding, dementia, elderly persons, outcomes
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 16 February 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.