Table 3 Characteristics and results of included food and drink modification, swallowing intervention, eating or drinking assistance and social support interventions
Study | Design | Setting, Intervention type | No. | Dementia stage | Dementia type | Effect on Nutrition / hydration status | Intake effect | Quality & other outcomes | Duration |
|---|---|---|---|---|---|---|---|---|---|
Swallowing interventions | |||||||||
Bautmans 2008 Belgium [56] | RCT | Nursing home. Cervical spine mobilization to help dysphagia | 15 | Severe | AD | NR | NR | ↑ Dysphagia limit | 1 week |
Germain 2006 Canada [57] | RCT | Long term care facility. Dysphagia diet | I = 8 C = 9 | NR | AD & others | ↑ Weight | ↑ E intake | NR | 12 weeks |
RCT | Hospitals & nursing homes. 1. Nectar-thick or 2. Honey-thick consistency fluids 3. Chin-tuck position | Nectar 133, Honey 123, Chin-tuck 259 | Various | NR | NR | → Aspiration pneumonia incidence (for thickened vs chin-tuck) | 3 months | ||
Food modification | |||||||||
RCT | Elderly nursing home residents. ONS, Gratin diet, swallowing problem management, exercise and oral care vs usual care | I = 54 C = 55 | NR | NR | ↑ BMI ↑ Weight | → E-intake ↑ Protein intake | → Cognitive performance → ADL | 11 weeks | |
Boffelli 2004 Italy [33] | CCT (BA) | Dementia unit. Diet & environment modification, feeding assistance and supplements | 29 | Severe | Various | → BMI → weight ↑ Albumin | NR | NR | 18 months |
Jean 1997 USA [59] | CCT (BA) | Nursing home. Finger food menu | 12 | NR | AD & others | ? Weight loss arrest | NR | ? Eating independence | 6 months |
CCT | Long term care facilities. Individualised food service, food modification, education and dietitian time | I = 33 C = 49 | NR | AD & others | ↑ weight | NR | NR | 21 months | |
RCT | 6 Care homes. Dining environment & menu changes | I = 57, C = 48 | NR | NR | → Weight, → BMI, → Hydrated | NR | → Enjoyment of food/drink | 1 year | |
Salas-Salvado 2005 Spain [61] | RCT | Geriatric institutions. Meal replacement with commercial lyophilised supplement | I = 15 C = 23 | Severe | AD | ↑ Weight ↑ Serum albumin | → E intake → Nutritional risk | → Eating behaviour → Mortality → Cognitive parameters | 3 months |
Soltesz 1995 USA [60] | CCT (BA) | Alzheimer’s Care Centre. Finger food provision | 43 | NR | AD | → Weight | ↑ Proportion food eaten | NR | 6 months |
RCT | Nursing home. High CHO dinners | I = 15 C 19 | NR | AD | NR | ↑ E intake | NR | 21 days | |
Eating or drinking assistance interventions | |||||||||
Boffelli 2004 Italy [33] | CCT (BA) | Dementia unit, diet & environment modification, feeding assistance and supplements | 29 | Severe | Various | → BMI → Weight ↑ Albumin | NR | NR | 18 months |
CCT | Nursing Homes. Staff assistance, prompting, food/drink service and exercise | I = 48 C = 15 | NR | NR | → Serum osmolality → BUN: creatinine ratio | → Food & fluid intake | NR | 32 weeks | |
Simmons 2008 USA [66] | RCT | Skilled nursing homes. Either meal time or between meal feeding assistance | I = 35 C = 34 | NR | NR | ? BMI, ? Weight | ↑ E intake | NR | 24 weeks |
Simmons 2010a USA [50] | RCT | Long-term care facilities. Between meal supplements & assistance vs usual care | I1 = 18 C 20 | NR | NR | → Weight | → E intake | NR | 6 weeks |
Simmons 2010b USA [50] | RCT | Long-term care facilities. Between meal snacks & assistance vs usual care | I2 = 25 C = 20 | NR | NR | →Weight | → E intake | NR | 6 weeks |
Wong 2008 New Zealand [67] | CCT (BA) | Short stay assessment unit.Individual mealtime assistance | 7 | NR | NR | ↑ BMI | ↑ E intake | NR | 12 weeks |
Studies with a strong social element around eating/drinking | |||||||||
Altus 2002 USA [68] | CCT (BA) | Locked dementia unit. Family-style meals −/+ staff training | 5 | Mod- severe | AD & others | NR | NR | ? Resident Participation in mealtime tasks ? Appropriate communication ? Praise statements ? Staff satisfaction with resident participation | 5 days each period |
Charras 2010 France [69] | CCT | Dementia units in nursing homes. Shared mealtime with staff | I = 8 C = 10 | Severe | AD | ↑ Weight | NR | ? Autonomy ? Quality of interactions ? Food quality | 6 months |
Huang 2009 Taiwan [70] | CCT (BA) | Older person care facility, Reminiscence cooking therapy | 12 | Mild-mod | NR | NR | NR | → MMSE ↑ Happiness → Communication ? Participation | 8 weeks |
Santo Pietro 1998 USA [71] | CCT | Dementia unit within a nursing home. Breakfast club (communication therapy) | I = 20 C = 20 | Mild-mod | AD | NR | NR | ↑ Interest & involvement ↑ Communication | 12 weeks |