Tube feeding in patients with dementia: where are we?

Dementia is a common diagnosis and accounts for significant morbidity and mortality. In the United States, the practice of medicine commonly dictated that dementia patients with dysphagia should receive a feeding tube. A review of the evidence in 1999 was completed to understand the validity of the premise of an improvement in a dementia patient's survival, quality of life, malnutrition, and comorbid diseases with tube feeding. The available literature reviewed was sparse. The retrospective and prospective observational studies noted no improvement in the above-mentioned outcomes in dementia patients with the use of tube feeding. Interestingly, a recent retrospective review denoted that dementia patients had no worse survival than patients with other diseases receiving a feeding tube and tube feedings. A prospective study comparing tube feeding to hand feeding in the dementia population is sorely needed.