D Volkert1. 1. Institut für Biomedizin des Alterns (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, 90408, Nürnberg, Deutschland. dorothee.volkert@fau.de.
Abstract
BACKGROUND: In the course of dementia sooner or later nutritional problems appear, and the question arises which interventions are effective in ensuring adequate nutrition and thus may contribute to the maintenance of health, functionality and independence. OBJECTIVE: This overview presents the state of knowledge regarding nutrition in dementia. METHODS: This work is based on the present guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) on nutrition in dementia, which systematically investigated relevant available evidence. RESULTS: Nutritional interventions should be an integral component of dementia treatment. They should be based on a routine screening for malnutrition, followed by assessment when appropriate, and periodic body weight control in order to recognize problems early. In all stages of dementia, adequate oral nutrition can be supported by attractive, high-quality food according to individual needs served in a pleasant ambience, by adequate nursing support and treatment of underlying causes of malnutrition. If nutritional requirements are not met by usual or enriched food, oral nutritional supplements are recommended in order to improve nutritional status. Beneficial effects of energy and/or nutrient supplementation on cognitive abilities are however not proven. Artificial nutrition is only rarely indicated, namely after careful weighing of individual benefits and risks considering the patients (presumed) will. In patients with advanced dementia and in the terminal phase of life artificial nutrition is not recommended.
BACKGROUND: In the course of dementia sooner or later nutritional problems appear, and the question arises which interventions are effective in ensuring adequate nutrition and thus may contribute to the maintenance of health, functionality and independence. OBJECTIVE: This overview presents the state of knowledge regarding nutrition in dementia. METHODS: This work is based on the present guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) on nutrition in dementia, which systematically investigated relevant available evidence. RESULTS: Nutritional interventions should be an integral component of dementia treatment. They should be based on a routine screening for malnutrition, followed by assessment when appropriate, and periodic body weight control in order to recognize problems early. In all stages of dementia, adequate oral nutrition can be supported by attractive, high-quality food according to individual needs served in a pleasant ambience, by adequate nursing support and treatment of underlying causes of malnutrition. If nutritional requirements are not met by usual or enriched food, oral nutritional supplements are recommended in order to improve nutritional status. Beneficial effects of energy and/or nutrient supplementation on cognitive abilities are however not proven. Artificial nutrition is only rarely indicated, namely after careful weighing of individual benefits and risks considering the patients (presumed) will. In patients with advanced dementia and in the terminal phase of life artificial nutrition is not recommended.
Authors: S Rivière; S Gillette-Guyonnet; T Voisin; E Reynish; S Andrieu; S Lauque; A Salva; G Frisoni; F Nourhashemi; M Micas; B Vellas Journal: J Nutr Health Aging Date: 2001 Impact factor: 4.075
Authors: A Salvà; S Andrieu; E Fernandez; E J Schiffrin; J Moulin; B Decarli; X Rojano-i-Luque; Y Guigoz; B Vellas Journal: J Nutr Health Aging Date: 2011-12 Impact factor: 4.075
Authors: Susan L Mitchell; Joan M Teno; Dan K Kiely; Michele L Shaffer; Richard N Jones; Holly G Prigerson; Ladislav Volicer; Jane L Givens; Mary Beth Hamel Journal: N Engl J Med Date: 2009-10-15 Impact factor: 91.245