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.
Cite this paper
Jaul, E. , Levin, R. and Menczel, J. (2014) Survival Effect of Tube Feeding in Patients with Advanced Dementia and Comorbidities. International Journal of Clinical Medicine
, 611-616. doi: 10.4236/ijcm.2014.511083
 Vitale, C.A., Monteleoni, C., Burke, L., Della Frazier, R. and Volicer, L. (2009) Strategies for Improving Care for Patients with Advanced Dementia and Eating Problems. Annals of Long Term Care, 17, 32-39.
 Gillick, M.R. (2000) Rethinking the Role of Tube Feeding in Patients with Advanced Dementia. New England Journal of Medicine, 342, 206-209. http://dx.doi.org/10.1056/NEJM200001203420312
 Mitchell, S.L., Teno, J.M., Kiely, D.K., Shaffer, M.L., Jones, R.N., Prigerson, H.G., Volicer, L., Givens, J.L. and Hamel, M.B. (2009) The Clinical Course of Advanced Dementia. New England Journal of Medicine, 361, 1529-1538. http://dx.doi.org/10.1056/NEJMoa0902234
 Finucane, T.E., Christmas, C. and Travis, K. (1999) Tube Feeding in Patients with Advanced Dementia. A Review of the Evidence. The Journal of the American Medical Association, 282, 1365-1370. http://dx.doi.org/10.1001/jama.282.14.1365
 American Geriatric Society Workgroup (2013) Identifies Five Things That Healthcare Providers and Patients Should Question. Journal of American Geriatric Society, 61, 622-631. http://dx.doi.org/10.1111/jgs.12226
 Sampson, E.L., Candy, B. and Jones, L. (2009) Enteral Tube Feeding for Older People with Advanced Dementia. Cochrane Database Systematic Reviews, 2, CD007209. http://dx.doi.org/10.1002/14651858.CD007209.pub2
 Teno, J.M., Gozalo, P., Mitchell, S.L., et al. (2012) Feeding Tubes and the Prevention or Healing of Pressure Ulcers. Archives of Internal Medicine, 172, 697-701. http://dx.doi.org/10.1001/archinternmed.2012.1200
 Finucane, T.E. and Bynum, J.P. (1996) Use of Tube Feeding to Prevent Aspiration Pneumonia. Lancet, 348, 1421-1424. http://dx.doi.org/10.1016/S0140-6736(96)03369-7
 Mitchell, S.L., Teno, J.M., Roy, J., et al. (2003) Clinical and Organizational Factors Associated with Feeding Tube Use among Nursing Home Residents with Advanced Cognitive Impairment. The Journal of the American Medical Association, 290, 73-80. http://dx.doi.org/10.1001/jama.290.1.41
 Jaul, E., Singer, P. and Calderon-Margalit, R. (2006) Tube Feeding in Demented Elderly with Severe Disabilities. Israel Medical Association Journal, 8, 870-874.
 Dwolatzky, T., Berezovski, S., Friedmann, R., Paz, J., Clarfield, A.M., Stessman, J., Hamburger, R., Jaul, E., Friedlander, Y., Rosin, A. and Sonnenblick, M. (2001) A Prospective Comparison of the Use of Nasogastric and Percutaneous Endoscopic Gastrostomy Tubes for Long-Term Enteral Feeding in Older People. Clinical Nutrition, 20, 535-540. http://dx.doi.org/10.1054/clnu.2001.0489
 Reisberg, B. (1998) Functional Assessment Staging (FAST). Psychopharmacology Bulletin, 24, 653-659.
 Teasdale, G. and Jennett, B. (1974) Assessment of Coma and Impaired Consciousness: Practical Scales. Lancet, 2, 81-84. http://dx.doi.org/10.1016/S0140-6736(74)91639-0
 Norton, D., McLaren, R. and Exton-Smith, A.N. (1962) An Investigation of Geriatric Nursing Problems in Hospital. Churchill Livingstone, London, 193-224.