Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 May 4:16:89.
doi: 10.1186/s12877-016-0256-8.

Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review

Diane K Bunn  1 , Asmaa Abdelhamid  1   2 , Maddie Copley  3 , Vicky Cowap  4 , Angela Dickinson  5 , Amanda Howe  1 , Anne Killett  6 , Fiona Poland  6 , John F Potter  1   7 , Kate Richardson  7 , David Smithard  8 , Chris Fox  1   9 , Lee Hooper  10
Affiliations
Meta-Analysis

Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review

Diane K Bunn et al. BMC Geriatr. .

Abstract

Background: Risks and prevalence of malnutrition and dehydration are high in older people but even higher in older people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions aiming to improve, maintain or facilitate food/drink intake indirectly, through food service or dining environment modification, education, exercise or behavioural interventions in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia).

Methods: We comprehensively searched Medline and twelve further databases, plus bibliographies, for intervention studies with ≥3 cognitively impaired adult participants (any type/stage). The review was conducted with service user input in accordance with Cochrane Collaboration's guidelines. We duplicated assessment of inclusion, data extraction, and validity assessment, tabulating data. Meta-analysis (statistical pooling) was not appropriate so data were tabulated and synthesised narratively.

Results: We included 56 interventions (reported in 51 studies). Studies were small and there were no clearly effective, or clearly ineffective, interventions. Promising interventions included: eating meals with care-givers, family style meals, soothing mealtime music, constantly accessible snacks and longer mealtimes, education and support for formal and informal care-givers, spaced retrieval and Montessori activities, facilitated breakfast clubs, multisensory exercise and multicomponent interventions.

Conclusions: We found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. A variety of promising indirect interventions need to be tested in large, high-quality RCTs, and may be approaches that people with dementia and their formal or informal care-givers would wish to try.

Trial registration: The systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014007611).

Keywords: Aged; Dehydration; Dementia; Diet; Drinking; Eating; Malnutrition; Meta-analysis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
EDWINA systematic review PRISMA flow diagram for studies of indirect interventions
See this image and copyright information in PMC

References

    1. Alzheimer’s Disease International: World Alzheimer Report 2013: An analysis of long-term care for dementia. http://www.alz.co.uk/research/world-report-2013 Accessed 25 08 2015; 2013.
    1. Meijers JM, Schols JM, Halfens RJ. Malnutrition in care home residents with dementia. J Nutr Health Aging. 2014;18:595–600. doi: 10.1007/s12603-014-0006-6. - DOI - PubMed
    1. Jesus P, Desport JC, Massoulard A, Villemonteix C, Baptiste A, Gindre-Poulvelarie L, et al. Nutritional assessment and follow-up of residents with and without dementia in nursing homes in the Limousin region of France: a health network initiative. J Nutr Health Aging. 2012;16:504–8. doi: 10.1007/s12603-012-0017-0. - DOI - PubMed
    1. Keller H, Beck AM, Namasivayam A. Improving food and fluid intake for older adults living in long-term care: A research agenda. J Am Med Dir Assoc. 2015;16:93–100. doi: 10.1016/j.jamda.2014.10.017. - DOI - PubMed
    1. Morley JE, Caplan G, Cesari M, Dong B, Flaherty JH, Grossberg GT, et al. International survey of nursing home research priorities. J Am Med Dir Assoc. 2014;15:309–12. doi: 10.1016/j.jamda.2014.03.003. - DOI - PubMed

Publication types