Enteral nutrition in patients with dementia and stroke.
OBJECTIVE
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.


RESULTS
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.


CONCLUSIONS
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.
Freeman
Cecilia
C
Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Ricevuto
Ashleigh
A
DeLegge
Mark H
MH
D000367:Age Factors; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D003704:Dementia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D009751:Nutritional Requirements; D009752:Nutritional Status; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome