Abstract
PURPOSE OF REVIEW
Patients suffering from dementia or significant cognitive impairment (SCI) due to neurologic injury routinely receive percutaneous endoscopic gastrostomy (PEG) due to swallowing difficulty or lack of appetite. This review discusses current data and opinion regarding the risks and benefits of PEG in these populations.
RECENT FINDINGS
The current data regarding PEG placement in patients with dementia or SCI due to neurologic injury do not confirm either improvement or worsening of survival. Significant risk factors for poor prognosis after PEG include sex, hypoalbuminemia, age, chronic heart failure, and subtotal gastrectomy. Complications associated with enteral nutrition are minor and easily controlled when managed by a nutritional team. Alternative options for feeding elderly demented patients are available for family members considering PEG.
SUMMARY
In contrast to previously published data regarding worse clinical outcomes in the dementia and SCI populations receiving PEG, recent data suggest that clinical outcomes in this population are no different than in other patient populations receiving PEG. A prospective, randomized study is needed to ascertain whether PEG is appropriate and beneficial in the dementia/SCI populations.
TY - JOUR
T1 - Enteral nutrition in patients with dementia and stroke.
AU - Freeman,Cecilia,
AU - Ricevuto,Ashleigh,
AU - DeLegge,Mark H,
PY - 2009/11/13/entrez
PY - 2009/11/13/pubmed
PY - 2010/5/13/medline
SP - 156
EP - 9
JF - Current opinion in gastroenterology
JO - Curr Opin Gastroenterol
VL - 26
IS - 2
N2 - PURPOSE OF REVIEW: Patients suffering from dementia or significant cognitive impairment (SCI) due to neurologic injury routinely receive percutaneous endoscopic gastrostomy (PEG) due to swallowing difficulty or lack of appetite. This review discusses current data and opinion regarding the risks and benefits of PEG in these populations. RECENT FINDINGS: The current data regarding PEG placement in patients with dementia or SCI due to neurologic injury do not confirm either improvement or worsening of survival. Significant risk factors for poor prognosis after PEG include sex, hypoalbuminemia, age, chronic heart failure, and subtotal gastrectomy. Complications associated with enteral nutrition are minor and easily controlled when managed by a nutritional team. Alternative options for feeding elderly demented patients are available for family members considering PEG. SUMMARY: In contrast to previously published data regarding worse clinical outcomes in the dementia and SCI populations receiving PEG, recent data suggest that clinical outcomes in this population are no different than in other patient populations receiving PEG. A prospective, randomized study is needed to ascertain whether PEG is appropriate and beneficial in the dementia/SCI populations.
SN - 1531-7056
UR - https://www.unboundmedicine.com/medline/citation/19907322/Enteral_nutrition_in_patients_with_dementia_and_stroke_
L2 - https://doi.org/10.1097/MOG.0b013e3283346fae
DB - PRIME
DP - Unbound Medicine
ER -