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

Research Article

Maddie Copley¹  David Smithard²  Kate Richardson³  Vicky Cowap⁴  Lee Hooper⁵  Diane K. Bunn⁵  Amanda Howe⁵  John F. Potter⁶  Chris Fox⁷  Asmaa Abdelhamid⁸  Fiona Poland⁹  Anne Killett⁹  Angela Dickinson^1,10 

[1] Age UK Norfolk, 300 St Faith’s Road, Old Catton, NR6 7BJ, Norwich, UK;King’s College Hospital NHS Foundation Trust, Denmark Hill, SE5 9RS, London, UK;Norfolk and Norwich University Hospital, Colney Lane, NR4 7UY, Norwich, UK;NorseCare, Lancaster House, 16 Central Avenue, St Andrew’s Business Park, NR7 0HR, Norwich, UK;Norwich Medical School, University of East Anglia, Norwich Research Park, NR4 7TJ, Norfolk, UK;Norwich Medical School, University of East Anglia, Norwich Research Park, NR4 7TJ, Norfolk, UK;Norfolk and Norwich University Hospital, Colney Lane, NR4 7UY, Norwich, UK;Norwich Medical School, University of East Anglia, Norwich Research Park, NR4 7TJ, Norfolk, UK;Norfolk and Suffolk NHS Foundation Trust, Hellesdon Hospital, Drayton High Road, NR6 5BE, Norwich, UK;Norwich Medical School, University of East Anglia, Norwich Research Park, NR4 7TJ, Norfolk, UK;Present address: Royal College of Paediatrics and Child Health, 5-11 Theobalds Road, WC1X 8SH, London, UK;School of Health Sciences, University of East Anglia, Norwich Research Park, NR4 7TJ, Norfolk, UK;School of Health and Social Work, University of Hertfordshire, AL10 9AB, Hatfield, Hertfordshire, UK;

关键词: Dementia;    Aged;    Eating;    Drinking;    Meta-analysis;    Diet;    Malnutrition;    Dehydration;   

DOI  :  10.1186/s12877-016-0256-8

 received in 2015-10-02, accepted in 2016-04-13,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundRisks and prevalence of malnutrition and dehydration are high in older people but even higher in older people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions aiming to improve, maintain or facilitate food/drink intake indirectly, through food service or dining environment modification, education, exercise or behavioural interventions in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia).MethodsWe comprehensively searched Medline and twelve further databases, plus bibliographies, for intervention studies with ≥3 cognitively impaired adult participants (any type/stage). 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. Meta-analysis (statistical pooling) was not appropriate so data were tabulated and synthesised narratively.ResultsWe included 56 interventions (reported in 51 studies). Studies were small and there were no clearly effective, or clearly ineffective, interventions. Promising interventions included: eating meals with care-givers, family style meals, soothing mealtime music, constantly accessible snacks and longer mealtimes, education and support for formal and informal care-givers, spaced retrieval and Montessori activities, facilitated breakfast clubs, multisensory exercise and multicomponent interventions.ConclusionsWe found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. A variety of promising indirect interventions need to be tested in large, high-quality RCTs, and may be approaches that people with dementia and their formal or informal care-givers would wish to try.Trial registrationThe systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014007611).

【 授权许可】

CC BY   
© Bunn et al. 2016