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Table 3 Summary of characteristics and results of 15 included educational interventions, reported in 15 studies (for further detail see Additional file 2)

From: Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review

Study Design Setting, intervention type No. of participants Dementia diagnosed Dementia stage Dementia type Effects on nutrition and/or hydration Effects on intake of food and/or drink and/or nutrients Quality effect (including QoL or meaningful activity) and other outcomes Duration
Altus 2002 [19] (Period 2) USA BA Locked dementia unit.
Family-style meals plus nurse training
5 Yes Mod-severe AD & others NR NR ? Suggested improvements in mealtime participation & communication, and staff praise statements, but no statistical significance provided. 5 days
Aselage 2011 [38] USA RCT Nursing home.
Staff education in eating & feeding skills
I = 4
C = 3
Yes Mod NR → Weight ? % Food consumed ? Fall in QoL likely but significance not reported
? Eating impairment
2 months
Faxen-Irving 2002 [39] Sweden CCT Group-living for people with dementia.
ONS & staff education vs usual care
I = 21
C = 12
Yes Mixed Mixed Education + ONS:
↑ BMI
↑ Weight
↑ TSF
→ AC
→ Albumin
→ Hb
After ONS withdrawn
↓ Weight
→ Nutrition risk Education + ONS:
→ Functional status
↓ Cognition (MMSE)
5 months
Hanson 2010 [37, 8184] USA RCT Nursing homes.
Education of surrogates on feeding options
I = 127
C = 129
Yes Severe NR ↓ Weight loss NR ? Knowledge, decisional conflict and certainty (only assessed for intervention group) 9 months
Jean 1997 [40] USA BA Nursing home.
Finger food menu plus staff training
12 NR NR AD & others ? Weight loss arrest ? ONS could be withdrawn in 25 % of participants ? Feeding independence 6 months
Kwok 2012 [41] Hong Kong RCT Old age hostels.
Resident & staff education with individual dietary counselling
I = 120
C = 149
Yes MCI N/A → Weight → Fruit intake
→ Vegetable intake
↑ fish intake
→ Cognitive status 33 months
Mamhidir 2007 [42] Sweden CCT Nursing homes.
Substantial staff training & support in integrity-promoting care
I = 18
C = 15
Yes Various Various ↑ Weight NR ? Mealtime environment & routines (Qualitative analysis of staff diaries) 3 months
Mentes 2003 [43, 85] USA BA Nursing homes.
Hydration management staff training
8 NR NR NR → Urine specific gravity → Fluid intake NR 4 weeks
NutriAlz Trial Salva 2009 [46, 8689] Spain RCT Outpatient clinics and hospital day-care centres.
Personalised nutrition education program for people with dementia & caregivers
I = 448
C = 498
Yes Mild-Mod AD, vascular & other → Weight,
→ BMI,
↑ MNA
NR → Eating behaviour,
→ Caregiver burden
→ Cognitive status
→ Functional status
12 months
Perivolaris 2006 [29] Period 2 Canada BA Long term care facility.
Staff education (1 day workshop to assist in providing meaningful dining experience)
11 Yes Mod-severe Various NR → E intake → Agitation
→Eating ability
→ Resident satisfaction
? Eating pace more leisurely
? Less wandering
? More relaxed.
6 weeks
Pivi 2011 [44] Brazil RCT Unclear.
People with dementia & caregiver nutritional education program
I = 25
C = 27
Yes Mild-severe AD ? BMI,
? Weight
? AC
→ TSF
→ Albumin
NR NR 6 months
Riviere 2001 [45] France, Italy & Spain CCT Living at home with informal care-giver.
Caregiver nutritional education
I = 151
C = 74
Yes NR AD ↑ Weight,
↑ MNA
NR → Functional status,
↓ Cognitive status
12 months
Suominen 2007 [47] Finland BA Nursing home.
Staff training
21 Yes Mod-severe NR → Weight, → BMI,
→ MNA
↑ E intake
↑ Protein intake
? Staff reported improved confidence in assessing intake and making nutritional changes 12 months
Suominen 2013 [48, 50, 90] Finland RCT Community.
Tailored nutritional training for people with dementia & spouses
I = 50
C = 50
Yes NR AD → Weight ↑ Protein intake ? Reported improvement in QoL 12 months
Wikby 2009 [49] Sweden CCT Residential care.
Dietary management staff training
I = 68
C = 59
NR NR NR → Weight
→ PEM
→ TSF
→ AC
NR ↑ Functional status,
↑ Cognition
4 months
  1. For abbreviations see below Table 2