Impact of Enteral Tube Feeding Compared to Oral Hand Feeding on Mortality, Pneumonia, Hospitalization and Quality of Life in Patients With Advanced Dementia: A Review

Abstract

\n \n \n To assess the effectiveness of enteral tube feeding in comparison to oral hand feeding in improving survival, hospitalization, pneumonia incidence, and quality of life in adults 60 years and older with advanced dementia.\n \n \n \n PubMed, CINAHL, Cochrane Library, and Academic Search Premier, supplemented by hand-searching, were probed for articles published between January 2006-June 2020. Eligible articles compared clinical outcomes (mortality, survival, pneumonia, hospitalization, and quality of life) amongst patients 60 years and older with advanced dementia, fed via an enteral tube or oral hand-feeding route. Of the 53 articles screened and assessed, 4 cohort studies involving 508 patients were extracted after excluding based on the above criteria and summarized for this review.\n \n \n \n Of the 4 articles, 3 were prospective cohort studies and 1 was a retrospective cohort study. Half of the studies reported significantly increased rates of mortality in groups of advanced dementia patients fed via enteral tube. Meanwhile, 1 study reported a similar nonsignificant increase in mortality rates in those fed via oral hand route. Half of the studies indicated a nonsignificant increase in hospitalization frequency for those fed via enteral tube. Additionally, 1 study reported an increased risk of pneumonia in patients fed via nasogastric tube. Regarding quality of life, 1 article reported significantly increased complaints of pain and discomfort from patients fed via oral hand feeding, that severity of dementia may have contributed to.\n \n \n \n Concerning clinical outcomes and mortality, these findings suggest no significant advantage to using enteral tube feeding options in older patients with advanced dementia. Thus, the healthcare professional should place primary emphasis on the patient s advance directives and provide the primary caregiver a thorough review of feeding options.\n \n \n \n None.\n