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Effects of a feeding intervention in patients with Alzheimer's disease and dysphagia.

AIMS AND OBJECTIVES
This study aimed to investigate the effects of a feeding intervention in patients with Alzheimer's disease with dysphagia.


BACKGROUND
In patients with Alzheimer's disease, inadequate food and fluid intake can result in malnutrition, dehydration and increased morbidity and mortality. Patients may lose self-care abilities such as self-feeding.


DESIGN
A prospective cohort study.


METHODS
A three-month self-control feeding intervention was conducted prospectively in 30 nursing home residents with Alzheimer's disease with dysphagia. Pre- and post-intervention measures included the Kubota water swallow test, type and amount of food intake and assessment of nutritional status by triceps skinfold thickness, upper arm circumference, serum albumin and haemoglobin. We used the Edinburgh Feeding Evaluation in Dementia scale to evaluate eating compliance and the Mini- Mental State Examination to evaluate cognitive function. Pre- and post-intervention results were compared to evaluate the effects of nursing intervention.


RESULTS
Patients' eating/feeding abilities improved overall, including significantly increased food intake (p < 0·001), decreased levels on the Kubota water swallow test (p < 0·001) and significant differences in skinfold thickness, arm circumference, serum albumin and haemoglobin (all p < 0·01), indicating improved nutritional status. Edinburgh Feeding Evaluation in Dementia scale scores decreased significantly, showing improved eating compliance. No changes were noted in cognition post-intervention. Among 22 patients who initially required feeding, five patients resumed self-feeding after the intervention (p = 0·06).


CONCLUSIONS
Results of this study show that a feeding intervention can improve food intake, eating compliance and nutritional status in patients with Alzheimer's disease with dysphagia and prevent further decline in swallowing function.


RELEVANCE TO CLINICAL PRACTICE
The significant improvement in eating/feeding measures suggest that this feeding intervention model could be developed as a feeding skills programme to improve both the eating/feeding care by nursing staff and the eating/feeding abilities and nutritional status of Alzheimer's disease patients.