[Artificial tube feeding of elderly suffering from advanced dementia]

Abstract

Background: There is a notable discord between physicians' opinions and reported practice regarding percutaneous endoscopic gastrostomy (PEG) nutrition in nursing homes for demented residents.

Aim: The aim of this study was to describe the decision and the outcomes of PEG placement in elderly nursing home residents, suffering from advance dementia and dysphagia.

Patients and method: The retrospective study evaluated frequency, complications of dysphagia and survival in 90 patients of Geriatric Center (61 women, 29 men) who underwent PEG. Average age was 85.7 +/- 0.8 years. Dysphagia diagnosed at 58, refusal of food of 36 patients. Following data was examined: age, time of dysphagia, anthropometric and laboratory tests.

Results: Post PEG complications were found in 62.2% of patients and lung aspiration was 38.7% among them. Mortality within 30 days was 14.4% and 1 year survival was 54.4%. Early mortality rate increased with advanced age (over 85 years old), lower serum albumin (< 3.0 gr/dl), hemoglobin (<1 1.0 gr/dl) and cholesterol (< 160 mg/dl), underweight (BMI < 20.0 kg/m2) and time of dysphagia less than 2 months.

Conclusion: Artificial tube feeding (PEG) of elderly nursing home residents, suffering from advanced dementia, may be clinically beneficial for most patients with dysphagia or meal rejection aside to gradual constriction of the indications for PEG, seeing aforesaid predictor factors.