title: Clinical evaluation of percutaneous endoscopic gastrostomy tube feeding in Japanese patients with dementia.
abstract: OBJECTIVE
  The aim of this study was to clinically evaluate percutaneous endoscopic gastrostomy (PEG) tube feeding of elderly Japanese patients with dementia.
  
  
  METHODS
  The records of the 155 patients with dementia who underwent PEG in Juntendo Tokyo Koto Geriatric Medical Center were reviewed for pertinent clinical data, including diagnosis of dementia, place of stay before and after hospitalization, as well as survival rate, albumin levels, and incidence of aspiration pneumonia (AP) before and 6 months after PEG feeding. The latter three data of these patients were compared with those of 106 patients with dementia fed through a nasogastric (NG) tube.
  
  
  RESULTS
  Alzheimer's disease and vascular dementia were predominant. Fifty-three percent of the patients were admitted from their home; the number of discharges to homes decreased to 21.2%. The mean (SD) of the albumin levels was 2.9 (0.4) g/dl before feeding and 2.9 (0.6) g/dl after 6 months. Among the patients with AP before PEG tube feeding, 51.6% had an AP recurrence. Conversely, AP occurred in 9.4% of the patients without AP before feeding. The patient survival rate was higher by 27 months when using PEG tube than when using an NG tube.
  
  
  CONCLUSIONS
  PEG tube feeding in patients with dementia leads to preservation of status for a few years. Compared with NG tube feeding, PEG tube feeding did not induce AP due to impairment of intact swallowing function, and was associated with higher survival rate of approximately 2 years. However, PEG tube feeding does not seem to promote home medical care.
authors: Department of Psychiatry, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan. kumagai@juntendo-urayasu.jp
authors: Ryo
authors: R
authors: Kumagai
authors: Masakazu
authors: M
authors: Kubokura
authors: Akari
authors: A
authors: Sano
authors: Mari
authors: M
authors: Shinomiya
authors: Shujiro
authors: S
authors: Ohta
authors: Yoshiro
authors: Y
authors: Ishibiki
authors: Kenji
authors: K
authors: Narumi
authors: Miyoji
authors: M
authors: Aiba
authors: Yosuke
authors: Y
authors: Ichimiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000628:therapy; D003704:Dementia / Q000628:therapy*; D015140:Dementia, Vascular / Q000628:therapy; D004724:Endoscopy / Q000009:adverse effects; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D007564:Japan / Q000453:epidemiology; D008297:Male; D009752:Nutritional Status; D011015:Pneumonia, Aspiration / Q000453:epidemiology / Q000209:etiology; D012709:Serum Albumin; D015996:Survival Rate
chemical_list: D012709:Serum Albumin