Use of nutritional complete supplements in older adults with dementia: systematic review and meta-analysis of clinical outcomes

Abstract

Background & aims: Malnutrition is prevalent in people diagnosed with dementia however ensuring adequate oral intake within this group is often problematic. It is important to determine whether providing nutritionally complete oral nutritional supplements (ONS) drinks is an effective way of improving clinical outcomes for older people with dementia. This paper systematically reviewed clinical, wellbeing and nutritional outcomes in people with long-term cognitive impairment.

Methods: The CINAHL, Medline and EMBASE databases were searched from their inception until January 2012. Reference lists of the included papers, foreign language papers and review articles obtained were manually searched.

Results: Twelve articles were included in the review containing 1076 people in the supplement groups (intervention) and 748 people in the control groups. Meta-analysis shows there was a significant improvement in weight (p = <0.0001), Body Mass Index (BMI) (p = <0.0001) and cognition at 6.5 ± 3.9 month follow-up (p = 0.002) when supplements were given compared to the control group.

Conclusions: Providing ONS drinks has a positive effect on weight gain and cognition at follow-up in older people with dementia. Additional research is required in both comparing nutritional supplements to vitamin/mineral tablets and high protein/calorie shots and clinical outcomes relevant to people with dementia.

Keywords: Aged; BMI; Dementia; Dietary supplements; Enteral nutrition; MAMC; MMSE; Meta-analysis; ONS; SE; SFT; Systematic review; body mass index; mid arm muscle circumference; mini-mental state examination; oral nutritional supplements; skin fold thickness; standard error.