Table 2 Characteristics and results of included oral nutrition supplementation (ONS) interventions

 Abalan 1992 France [30]

RCT

Geriatric inpatients. Proprietary ONS (‘Tonexis’) vs usual food

I = 15

C = 14

NR

AD

N/A

→ E intake

↑ Cognitive function

15 weeks

 Beck 2002 Denmark [32]

RCT

Nursing home (risk of malnourishment). Home-made ONS vs usual food

I = 8

C = 8

NR

NR

→ Weight

→ E intake

N/A

2 months

 Carlsson 2009 Sweden [34]

CCT (BA)

Group-living facilities for people with dementia. Drinkable yogurt

13

NR

Mixed

↓ Weight

→ E intake

→ Fluid intake

→ Functional status

6 months

 Carver 1995 UK [36]

RCT

Psychiatric hospital/elderly ward (under-weight).

Proprietary ONS (‘Fortisip’) vs placebo

I = 20

C = 20

NR

NR

↑ Weight

↑* BMI

→TSF

↑ MAMC

N/A

N/A

12 weeks

 de Sousa 2012 Portugal [37]

RCT

Psychiatric hospital, geriatric unit, mild dementia patients (malnourished).

ONS vs usual care & advice

I = 20

C = 15

Mild

AD

↑ Weight

 ↑ BMI

↓ Nutritional risk

→ Functional status

→ Cognitive function

3 weeks

 Faxen-Irving 2002 Sweden [38]

CCT

Group-living for people with dementia.

ONS & diet advice vs usual care

I = 21

C = 12

Mixed

Mixed

↑^a Weight

↑^a BMI

↑‡ TSF

→ AMC

N/A

→ ADL

↓ Cognitive function

5 months

 FICSIT Fiatarone Singh 2000 USA [39, 86–88]

RCT

Nursing home (long term rehabilitation centre).

ONS vs placebo

I = 24

C = 26

NR

NR

↑ Weight

↑ BMI

→ MAMA

→ TBW

→ E intake

→ Fluid intake

→Functional status

10 weeks

 FOPANU Carlsson 2011 Sweden [35, 89, 90]

RCT

Residential care facilities.

Protein-enriched drink (+/− exercise) vs placebo drink (+/− exercise)

I = 96

C = 95

NR

NR

→ Weight

→ ICW

N/A

→ Balance

→ Gait

→ Lower limb strength

3 months

 Gregorio 2003 Spain [40]

RCT

Nursing home residents with AD.

Proprietary ONS (‘Nutrison’) vs usual food

IG = 24

C = 74

Mod

AD

↑* BMI

↓* Nutritional risk

N/A

12 months

 Lauque 2000 France [44]

RCT

Nursing homes (risk of malnourishment).

Proprietary ONS (Clinutren, Nestle) vs usual food

I = 19

C = 22

NR

NR

→ Weight

→ BMI

↑ E intake

↑ Protein intake

→ Grip strength

2 months

 Lauque 2004 France [45]

RCT

Geriatric wards & day centres (risk of malnourishment). Proprietary ONS (Clinutren) vs usual food

I = 37

C = 43

Mod

NR

↑ Weight

↑ BMI

↑ E intake

↓ Nutritional risk

→ADL

→ Cognitive function

→ Eating behaviour

3 months

 Manders 2009 Netherlands [46]

RCT

Nursing homes.

ONS vs placebo

I = 78

C = 33

NR

NR

↑ Weight

↑ Calf circumference

N/A

→ Functional status

→ Grip strength

→ Cognitive status

24 weeks

 Navrátilová 2007 Czech Republic [47]

RCT

Institutionalised residents with AD (type of institution unclear).

Proprietary ONS (‘Nutridrink’) vs usual food

I = 50

C = 50

NR

AD

→ Weight

→ BMI

↑^† E intake

↑^† Protein intake

↑ Cognitive function

1 year

 Pivi 2011 Brazil [55]

RCT

Setting unclear. Proprietary supplement (Ensure with FOS®) vs usual care

I = 26

C = 27

Mild-severe

AD

↑* Weight

↑* BMI

↑* AMC

↑* AC

 → TSF

N/A

N/A

6 months

 Planas 2004 Spain [48]

CCT (BA)♣

Dementia care day centre.

ONS +/− micronutrients

I = 23

C = 21

Mild

AD

→ BMI

↑ MAMC

↑ TSF

↑ E intake

→ Cognitive function

6 months

 Simmons 2010a USA [50]

RCT

Long-term care facilities, type unclear. Between meal nutritional supplements vs. usual care

I = 18

C = 20

NR

NR

→ Weight

→ E intake

↑ Costs & staff time

6 weeks

 Souvenir I

 Scheltens 2010 USA & Europe [49, 91–96]

CCT (BA)♣

AD Treatment Centres.

Proprietary ONS (Souvenaid) vs isocaloric placebo

I = 98

C = 97

Mild

AD

→ BMI

N/A

→ Cognitive function

→ QoL

12 & 24 weeks

 Stange 2013 Germany [51, 97–99]

RCT

Nursing home (risk of malnutrition).

ONS vs usual care

I = 45

C = 42

Mod-severe

NR

↑ Weight

→ BMI

↑ UAC

↑ Calf circumference

→ E intake

→ Protein intake

→ Nutritional risk

→ Cognitive function

→ ADL

12 weeks

 Wouters-Wesseling 2002 Netherlands [53]

RCT

Nursing homes, residents with dementia.

ONS vs placebo

I = 19

C = 16

NR

Mixed

↑ Weight

→ BMI

N/A

→ Functional status

12 weeks

 Wouters-Wesseling 2006 Netherlands [52]

RCT

Psychogeriatric nursing homes (with acute infection).

ONS vs usual care

I = 18

C = 16

NR

NR

→ Weight

→ TST

→ AMC

→ E intake

→ Functional status

5 weeks

 Young 2004 Canada [54, 62, 100]

RCT

Dementia units within a nursing home. ONS vs high carbohydrate meals

I = 15

C = 19

NR

AD

↑ Weight

↑ E intake

↑ Protein intake

N/A

3 weeks

 Krikorian 2010a USA [42]

RCT

Community-dwelling.

Grape juice vs placebo

I = 5

C = 7

MCI

N/A

→* Weight

→* Waist

N/A

↑ Learning,

→ Spatial awareness,

→ Recall

12 weeks

 Krikorian 2010b USA [43]

CCT

Community-dwelling.

Blueberry juice vs placebo

I = 9

C = 7

MCI

N/A

→* Weight

→* Waist

N/A

? Cognition,

? Spatial awareness

12 weeks

 Krikorian 2012 USA [41]

RCT

Community-dwelling.

Grape juice vs placebo

I = 10

C = 11

MCI

N/A

→ Weight

→ Waist

N/A

NR

16 weeks

 Simmons 2010b USA [50]

RCT

Long-term care facilities.

Between meal snacks & assistance vs usual care

I = 25

C = 20

NR

NR

→ Weight

→ E intake

↑ Costs

↑ Staff time

6 weeks

 Beck 2010 Denmark [31, 101]

RCT

Elderly nursing home residents.

ONS, Gratin diet, exercise, oral care vs usual care

I = 54

C = 55

NR

NR

↑ Weight

↑ BMI

→ E intake

↑ Protein intake

→ Cognitive performance

→ ADL

11 weeks

 Boffelli 2004 Italy [33]

CCT (BA)

Malnourished residents of dementia unit. Individualised diet including mealtime assistance, environmental modification and ONS if required

19

Severe

Mixed

→ Weight

→ BMI

↑ Serum albumin

N/A

N/A

18 months