Effectiveness of interventions to directly support food and drink intake in people with dementia:systematic review and meta-analysis

Abdelhamid, Asmaa, Bunn, Diane K., Copley, Maddie ORCID: https://orcid.org/0000-0001-8815-006X, Cowap, Vicky, Dickinson, Angela, Gray, Lucy, Howe, Amanda, Killett, Anne, Lee, Jin, Li, Francesca, Poland, Fiona ORCID: https://orcid.org/0000-0003-0003-6911, Potter, John F., Richardson, Kate, Smithard, David, Fox, George ORCID: https://orcid.org/0000-0001-9480-5704 and Hooper, Lee ORCID: https://orcid.org/0000-0002-7904-3331 (2016) Effectiveness of interventions to directly support food and drink intake in people with dementia:systematic review and meta-analysis. BMC Geriatrics, 16. ISSN 1471-2318

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Background: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking. Methods: We comprehensively searched 13 databases for relevant intervention studies. The review was conducted with service user input in accordance with Cochrane Collaboration’s guidelines. We duplicated assessment of inclusion, data extraction, and validity assessment, tabulating data, carrying out random effects meta-analysis and narrative synthesis. Results: 43 controlled interventions were included, disappointingly none were judged at low risk of bias. Oral nutritional supplementation studies suggested small positive short term but unclear long term effects on nutritional status. Food modification or dysphagia management studies were smaller and of low quality, providing little evidence of an improved nutritional status. Eating assistance studies provided inconsistent evidence, but studies with a strong social element around eating/drinking, although small and of low quality provided consistent suggestion of improvements in aspects of quality of life. There were few data to address stakeholders’ questions. Conclusions: We found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. People with cognitive impairment and their carers have to tackle eating problems despite this lack of evidence, so promising interventions are listed. The need remains for high quality trials tailored for people with cognitive impairment assessing robust outcomes. Systematic review registration: The systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero.

Item Type: Article
Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords: dementia,aged,eating,drinking,meta-analysis ,diet,malnutrition,dehydration,sdg 2 - zero hunger ,/dk/atira/pure/sustainabledevelopmentgoals/zero_hunger
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User: Pure Connector
Date Deposited: 22 Jan 2016 17:00
Last Modified: 22 Oct 2022 00:36
URI: https://ueaeprints.uea.ac.uk/id/eprint/56755
DOI: 10.1186/s12877-016-0196-3

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