Patients with advanced dementia frequently develop eating difficulties
and weight loss. Enteral feeding tubes are often used in this situation, yet
benefits and risks of this therapy are unclear. We searched MEDLINE, 1966
through March 1999, to identify data about whether tube feeding in patients
with advanced dementia can prevent aspiration pneumonia, prolong survival,
reduce the risk of pressure sores or infections, improve function, or provide
palliation. We found no published randomized trials that compare tube feeding
with oral feeding. We found no data to suggest that tube feeding improves
any of these clinically important outcomes and some data to suggest that it
does not. Further, risks are substantial. The widespread practice of tube
feeding should be carefully reconsidered, and we believe that for severely
demented patients the practice should be discouraged on clinical grounds.
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