Summary of the Systematic Review

Article Citation

Effectiveness of Interventions to Directly Support Food and Drink Intake in People With Dementia: Systematic Review and Meta-Analysis

Abdelhamid, A., Bunn, D., et al. (2016).
BMC Geriatrics, 16, 26.
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Sponsoring Body

National Institute for Health Research (United Kingdom); Collaboration for Leadership in Applied Health Research & Care, East ofEngland (United Kingdom)

Article Quality Ratings

Read about Our Rating Process

Indicators of Review Quality

  • Yes The review states a clearly focused question/aim.
  • Yes Criteria for inclusion of studies are provided.
  • Yes Search strategy described in sufficient detail for replication.
  • Yes Included studies are assessed for study quality.
  • Yes Quality assessments are reproducible.
  • Yes Characteristics of the included studies are provided.

Quality Rating Notes

Search Strategy and Study Quality: See supplementary materials for full systematic review methodology, study characteristics and quality assessments. Specific details about the literature search is available in an article listed below under Notes on This Section.

Article Details

Description

This is a systematic review of the research examining the effectiveness of direct and indirect treatments used to maintain or facilitate oral intake in individuals with dementia with and without dysphagia.

Questions/Aims Addressed

  1. What are the most effective ways to encourage people with dementia to eat, drink and maintain nutritional intake? 
  2. For people with dementia, what interventions can help to maintain or improve food intake or nutritional status? 
  3. For people with dementia, what interventions can help to maintain or improve fluid intake or hydration status? 
  4. For people with dementia living in their own homes with a carer, what interventions can help to maintain or improve food intake or nutritional status? 
  5. For people with dementia living in their own homes with a carer, what interventions can help to maintain or improve fluid intake or hydration status? 
  6. For people with Alzheimer’s dementia, what interventions can help to maintain or improve food intake or nutritional status? 
  7. For people with Alzheimer’s dementia, what interventions can help to maintain or improve fluid intake or hydration status? 
  8. For people with dementia, what interventions aimed at improving or maintaining food and/or fluid intake, nutrition or hydration status, support meaningful activity (activity around food or drink that is personally fulfilling, that people enjoy, look forward to or find important)? 
  9. For people with dementia, are there any interventions that; worsen food or fluid intake, worsen enjoyment or quality of life, or worsen meaningful activity or social inclusion? 
  10. Do individualised interventions appear more effective than those that are not individualised, in helping people with dementia to maintain or improve food and/or drink intake, nutrition or hydration status (or related outcomes)? 
  11. Do interventions to assess swallowing (and where necessary treat swallowing problems) have any effect on food or drink intake, nutrition or hydration status (or related outcomes)? 
  12. Do interventions to improve oral hygiene have any effect on food or drink intake, nutrition or hydration status (or related outcomes)?
  13. For people with dementia living in the community, does type of carer providing the intervention affect the outcomes (e.g. close relative vs paid carer, full time vs occasional carer)? 
  14. For people with dementia, does emotional closeness of the carer (e.g. close relative vs paid carer) affect the outcomes? 
  15. Are there any interventions that are particularly effective in helping people with dementia to maintain or improve food and/or drink intake, nutrition or hydration status (or related outcomes) during periods of acute illness? 

Population

Adults with diagnosis of dementia or mild cognitive impairment.

Intervention/Assessment

Any direct or indirect intervention aimed at maintaining or facilitating oral intake. Direct interventions included diet modification or use of food based supplements. Indirect modifications included altering environment, caregiver/patient education and training, behavioral interventions, or exercise-based treatments.

Number of Studies Included

43

Years Included

Not stated


Conclusions from This Systematic Review

What are Conclusions?

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Treatment

Of the 43 studies included, only three examined interventions aimed at treating or managing dysphagia in individuals with Alzheimer's disease or mild cognitive impairment. Interventions included diet modification and/or postural maneuvers. Findings revealed limited evidence supporting the use of these interventions to improve nutritional intake. Further research is needed to determine the effectiveness or lack of effectiveness of specific swallowing interventions aimed at improving or maintaining oral intake in this population. 

Keywords: Diagnosis, Alzheimer’s Disease, Diet Modifications, Dementia, Diet Modification, Swallowing, Mild Cognitive Impairment, Postural Changes, Postural Techniques/Maneuvers

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Treatment

Of the 43 studies included, only three examined interventions aimed at treating or managing dysphagia in individuals with Alzheimer's disease or mild cognitive impairment. Interventions included diet modification and/or postural maneuvers. Findings revealed limited evidence supporting the use of these interventions to improve nutritional intake. Further research is needed to determine the effectiveness or lack of effectiveness of specific swallowing interventions aimed at improving or maintaining oral intake in this population. 

Keywords: Diagnosis, Alzheimer’s Disease, Diet Modifications, Dementia, Diet Modification, Swallowing, Mild Cognitive Impairment, Postural Changes, Postural Techniques/Maneuvers

Notes on This Article

This systematic review was reviewed with the following article, also published by the authors, however, not relevant to SLP practice:

  • Bunn, D. K., Abdelhamid, A., et al. (2016). Effectiveness of Interventions to Indirectly Support Food and Drink Intake in People With Dementia: Eating and Drinking Well IN dementiA (EDWINA) Systematic Review. BMC Geriatrics, 16, 89. doi:10.1186/s12877-016-0256-8

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