Table 2.
Summary of studies on the benefits of tube feeding in individuals with advanced dementia.
| Article | Participants | Study design (follow-up) | Aim | Outcome/conclusion |
|---|---|---|---|---|
| Nunes et al. [90] | 46 patients | Retrospective study (80 months) | Examined the effectiveness of PEG feeding for nutritional support in patients with dementia | PEG feeding improves low albumin including the serum markers of malnutrition and poor clinical outcome; serum albumin levels (95% CI: 3.3–3.6; P < 0.01) and transferrin levels (95% CI: 182–206; P < 0.05) were significantly improved after 3 months of PEG feeding; high albumin, transferrin, and cholesterol levels at admission were positively correlated with survival Mean and median survivals after PEG placement were 21 and 18 months, respectively |
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| Giantin et al. [99] | 261 patients (155 PEG-fed; 106 NG tube-fed) | Survey study (6 months before and after analysis) | Clinical evaluation of elderly Japanese patients with dementia who underwent PEG feeding versus NG- tube feeding | Survival rates among PEG-fed patients were 27 months higher than those fed via NG tubes (mean (SD): PEG group, 65.6 (5.6%) versus NG tube group, 44.4 (9.8%); P=0.019) PEG feeding provided evidence of reduced incidence of aspiration pneumonia when compared with NG tube feeding |
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| Takenoshita et al. [100] | 58 patients (46 with tube feeding and 12 without) | Retrospective study (60 months) | Evaluated the frequency of pneumonia before and after tube feeding in severe dementia patients | Tube feeding decreased pneumonia and antibiotic use in patients with severe dementia compared with those without tube feeding Tube feeding was associated with significantly longer survival (hazard ratio 9.8, 95% CI 3.6–27.0, p < 0.001); advanced dementia patients on tube feeding had median survival times of 23 months compared with median survival times of two months among those without tube feeding |
| Cúrdia et al. [106] | 60 patients (26 dementia; 18 stroke; 5 head injury; 3 anoxic encephalopathy; 2 ALS; 3 other conditions) | Prospective study (24 months) | Analyzed the global impact of PEG feeding in patients followed-up in specialised multidisciplinary PEG clinic | 6-month period after PEG placement showed significant decrease in the mean number of emergency department visits compared with 6 months before PEG insertion (1.1 vs. 2.2; P=0.003) as well as the mean number for hospital admissions (0.3 vs 1.4; P < 0.001). respectively 53.8% of patients with pre-existing pressure ulcers had complete healing after PEG placement at 6-month follow-up PEG feeding improved biochemical markers (such as haemoglobin, albumin, and total proteins) that reflected better nutrition and hydration in the patients |
| Shintani [108] | 80 patients | Retrospective study (5 years) | Compared survival periods of elderly patients with neurologic impairments in those receiving oral intake, PEG feeding or home parenteral nutrition | Survival periods of the advanced cognitively-impaired elderly receiving PEG feeding (736 ± 765 days) were nearly as twice that of the elderly adults having oral intake (399 ± 257 days); home parenteral nutrition survival was 736 ± 765 days |
| Takayama et al. [109] | 185 patients (129 dementia; 44 schizophrenia; 6 mood disorders; 6 others) | Retrospective study (>1000 days) | Compared the survival times with or without tube feeding in patients with dementia or psychiatry disease | Median survival times were longer for dementia patients with tube feeding (695 days) compared With those without tube feeding (75 days P < 0.001) About 75% of the dementia patients with tube feeding survived more than a year, and about 50% of them survived more than two years |
| Higaki et al. [113] | 311 patients | Retrospective cohort study (3 years) | Compared survival outcomes of elderly patients with and without dementia after PEG placement | Survival or mortality was not significantly different in the patients with dementia and those without dementia (P=0.62) |
| Orlandoni et al. [122] | 585 patients | Retrospective observational study (5 years) | Compared the outcomes and harmful effects of home tube feeding in patients with advanced dementia and patients without dementia | No difference was found between the incidence rates of mechanical, gastrointestinal, or metabolic complications in patients with advanced dementia compared with patients without dementia No evidence to support that tube feeding led to poorer prognosis or low survival in patients with dementia compared with patients without dementia (p > 0.05). |
| Malmgren et al. [123] | 191 patients (16 dementia; 95 stroke; 11 Parkinson's disease; 35 malignancy; 13 neurological diseases; 19 miscellaneous) | Retrospective study (5 years) | Evaluated the indications and survival after PEG insertion in patients older than 65 years | Overall median survival was 123 days, and 30-day mortality was 22% Patients with dementia or Parkinson's disease had the longest median survival, which was 244 and 233 days, respectively, while patients with other neurological diseases and malignancy had the shortest median survival, 75 and 106 days, respectively |