Survival Effect of Tube Feeding in Patients with Advanced Dementia and Comorbidities

Abstract

Patients suffering from advanced dementia who have difficulties in eating and swallowing are often tube fed (TF). They suffer, on most occasions, from additional diseases. The effect of tube feeding in advanced dementia patients is controversial and is largely discussed in the medical literature. The purpose of the present study, is to report the effect of tube feeding on the survival time in patients with advanced dementia who suffered from additional diseases. One hundred and forty nine patients with Functional Assessment Stage of Alzheimer Disease (FAST) stage 5>, hospitalized in skilled geriatric nursing department between July 2008 and December 2011 were included in the study. Oral and tub feeding was decided following the evaluation by speech therapists at admission. 99 (66.5%) of the patients were tube fed and 50 (33.5%) received oral feeding at admission. The mean age was 80 ± 11. Sixty four percent of the patients were admitted from general hospitals. Comorbidities were significantly higher in the tube fed group, median survival time was 164 days. The median survival time of the OF group was 78 days (χ2 = 0.94; p = 0.33). Prevalence of tube feeding increased significantly from 53.85% to 90.9% in patients with 3 risk factors such as pressure ulcers, low Hgb and low BMI. The survival time of the tube fed patients was longer compared to patients who were orally fed. Tube feeding in patients with dementia continues to be controversial, and additional researchable data are helpful in the decision to insert a tube.