Hand-fed dementia sufferers see 40% decrease threat of pneumonia than those that are tube-fed

A collaboration examine led by researchers from the Division of Geriatrics, Division of Drugs, College of Scientific Drugs, LKS College of Drugs at The College of Hong Kong (HKUMed) has discovered that superior dementia sufferers with feeding issues initiated on cautious hand feeding had a threat of pneumonia 40% decrease than these on nasogastric tube feeding. The analysis article is now printed on-line within the Journal of the American Medical Administrators Affiliation.

Sufferers with superior dementia with feeding issues corresponding to poor oral consumption and dysphagia are sometimes initiated on tube feeding. Feeding tubes are inserted because of the perceived advantages of decreasing the chance of aspiration pneumonia and enhancing survival. Nevertheless, this has not been proven in earlier observational research carried out abroad. Lately, some geriatric wards in Hong Kong have begun to supply the choice of cautious hand feeding as a substitute for tube feeding to advertise consolation and high quality of life in end-of-life sufferers with feeding issues.

The analysis staff carried out the primary examine in Hong Kong of hospitalized sufferers with superior dementia with feeding issues to match the threat of pneumonia and loss of life between these initiated on cautious hand feeding versus nasogastric tube feeding.

Analysis findings

The retrospective cohort examine recognized 764 sufferers with superior dementia thought-about for tube feeding because of feeding issues. The findings confirmed that sufferers initiated on cautious hand feeding had a threat of pneumonia 40% decrease than these on nasogastric tube feeding.

There was no vital distinction in one-year survival between the nasogastric tube feeding and cautious hand feeding teams, with a median survival of 125 and 145 days respectively.

This examine gives proof that, opposite to standard knowledge, nasogastric tube feeding doesn’t confer survival advantages in contrast with cautious hand feeding in sufferers with superior dementia. Furthermore, nasogastric tube feeding is related to an elevated threat of pneumonia in contrast with cautious hand feeding on this affected person inhabitants. Postulated mechanisms for elevated aspiration threat with nasogastric tube feeding embody impairment of the decrease esophageal sphincter, desensitization of the pharyngoglottal reflex, and reflux of gastric contents into the pharynx.

“Because the follow of tube feeding in superior dementia sufferers stays prevalent in Hong Kong and lots of components of the world, this analysis highlights the necessity for additional schooling of the general public and healthcare suppliers to enhance evidence-based follow round tube feeding choices in dementia sufferers,” mentioned Dr. Jacqueline Yuen Kwan-yuk, Scientific Assistant Professor of the Division of Geriatrics, Division of Drugs, College of Scientific Drugs, HKUMed.