Factors affecting independence in eating among elderly with Alzheimer's disease.
OBJECTIVE
In elderly patients with dementia, disturbed eating behavior is understood to be a core symptom or a behavioral and psychological symptom of dementia (BPSD). The purpose of the present study was to investigate the factors affecting self-feeding in elderly patients with Alzheimer's disease (AD).


METHODS
A total of 150 AD patients who were hospitalized in dementia wards, or were residents of institutions or group homes were enrolled. The patients underwent an eating behavior examination, cognitive assessment, neurological examination and vital function tests. The eating behavior examination consisted of observation of the patients at mealtime. Items assessing eating behavior included the number of feeding cycles, stopping of eating or agitation and dysfunction.


RESULTS
Logistic regression analysis carried out to identify factors with a significant effect on decreased independence in eating were difficulty in beginning a meal (OR = 14.498, CI = 2.067-101.690), presence of dysphagia signs (OR = 5.214, CI = 1.031-26.377) and the severity of dementia (OR = 4.538, CI = 1.154-17.843).


CONCLUSIONS
The present study is the first to generate objective data showing that difficulty in beginning a meal is a factor that hinders independence in eating in AD, in addition to the presence of dysphagia signs and the severity of dementia. Assisting AD patients in maintaining eating independence might be effectively achieved by eliminating environmental factors that interfere with beginning a meal, and by providing assistance that will promote beginning a meal. The present results show the necessity of developing effective methods for assisting elderly patients with AD.
Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba, Japan.
Ayako
A
Edahiro
Hirohiko
H
Hirano
Ritsuko
R
Yamada
Yumi
Y
Chiba
Yutaka
Y
Watanabe
Morio
M
Tonogi
Gen-yuki
GY
Yamane
D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology*; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000503:physiopathology; D003680:Deglutition Disorders / Q000503:physiopathology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D009460:Neurologic Examination; D012307:Risk Factors; D012720:Severity of Illness Index