Mealtime difficulty in older people with dementia

Salma Rehman,Roger Watson,Gloria Likupe

doi:10.15347/wjm/2019.006

Abstract

Aim: To evaluate the evidence published in systematic reviews on the effectiveness of interventions aimed at alleviating mealtime difficulties in older people with dementia. Background: Older people with dementia gradually lose their self-care abilities as the condition of dementia progresses and this includes the ability to eat independently. There is a large body of research into this phenomenon, including into the effectiveness of interventions to alleviate the problems which arise. Recently there have also been several systematic reviews with different conclusions about the effectiveness of these interventions.

Highlights

Dementia is a syndrome describing the effect of several diseases which are common in older people
Methodological problems related to sample size and bias were apparent in the studies included in all the reviews and there was a lack of standardisation around interventions and outcomes across studies
Registration: The review is registered on PROSPERO[1]

Summary

Introduction

Dementia is a syndrome describing the effect of several diseases which are common in older people. The evidence-base for purportedly effective interventions was almost non-existent until the first decade of the present century and a review published in 2006 but reviewing articles up to 2003[6] confirmed this and outlined the multiple problems associated with research in this area. Given the fact that all studies reported positively on effective interventions, even without substantial evidence, reporting bias was probably an issue among the studies It is notable, that none of the studies on mealtime difficulty to date have considered aspects associated with food and eating in different cultures. Since around the time of the review by Watson and Green[6] more rigorous studies have been evident and especially since 2010 there has been a growth in better studies designed to alleviate mealtime difficulties of older people with dementia. There has been a growth in systematic reviews purporting to evaluate the evidence and the purpose of this article is to conduct a systematic review of those reviews to see if any conclusions can be drawn about which interventions are effective

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