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Effectiveness of interventions to directly support food and drink intake in people with dementia: systematic review and meta-analysis

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Effectiveness of interventions to directly support food and drink intake in people with dementia : systematic review and meta-analysis. / Abdelhamid, Asmaa; Bunn, Diane K.; Copley, Maddie; Cowap, Vicky ; Dickinson, Angela; Gray, Lucy; Howe, Amanda; Killett, Anne; Lee, Jin; Li, Francesca ; Poland, Fiona; Potter, John F.; Richardson, Kate; Smithard, David; Fox, George; Hooper, Lee.

In: BMC Geriatrics, Vol. 16, 26, 22.01.2016.

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@article{cfd5915e2e7b494aa934466ecc8cc4a2,
title = "Effectiveness of interventions to directly support food and drink intake in people with dementia: systematic review and meta-analysis",
abstract = "Background: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking. Methods: We comprehensively searched 13 databases for relevant intervention studies. The review was conducted with service user input in accordance with Cochrane Collaboration{\textquoteright}s guidelines. We duplicated assessment of inclusion, data extraction, and validity assessment, tabulating data, carrying out random effects meta-analysis and narrative synthesis. Results: 43 controlled interventions were included, disappointingly none were judged at low risk of bias. Oral nutritional supplementation studies suggested small positive short term but unclear long term effects on nutritional status. Food modification or dysphagia management studies were smaller and of low quality, providing little evidence of an improved nutritional status. Eating assistance studies provided inconsistent evidence, but studies with a strong social element around eating/drinking, although small and of low quality provided consistent suggestion of improvements in aspects of quality of life. There were few data to address stakeholders{\textquoteright} questions.Conclusions: We found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. People with cognitive impairment and their carers have to tackle eating problems despite this lack of evidence, so promising interventions are listed. The need remains for high quality trials tailored for people with cognitive impairment assessing robust outcomes. Systematic review registration: The systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero.",
keywords = "Dementia, Aged, Eating, Drinking, Meta-analysis , Diet, Malnutrition, Dehydration",
author = "Asmaa Abdelhamid and Bunn, {Diane K.} and Maddie Copley and Vicky Cowap and Angela Dickinson and Lucy Gray and Amanda Howe and Anne Killett and Jin Lee and Francesca Li and Fiona Poland and Potter, {John F.} and Kate Richardson and David Smithard and George Fox and Lee Hooper",
note = "This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.",
year = "2016",
month = jan,
day = "22",
doi = "10.1186/s12877-016-0196-3",
language = "English",
volume = "16",
journal = "BMC Geriatrics",
issn = "1471-2318",
publisher = "BioMed Central",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Effectiveness of interventions to directly support food and drink intake in people with dementia

T2 - systematic review and meta-analysis

AU - Abdelhamid, Asmaa

AU - Bunn, Diane K.

AU - Copley, Maddie

AU - Cowap, Vicky

AU - Dickinson, Angela

AU - Gray, Lucy

AU - Howe, Amanda

AU - Killett, Anne

AU - Lee, Jin

AU - Li, Francesca

AU - Poland, Fiona

AU - Potter, John F.

AU - Richardson, Kate

AU - Smithard, David

AU - Fox, George

AU - Hooper, Lee

N1 - This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.

PY - 2016/1/22

Y1 - 2016/1/22

N2 - Background: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking. Methods: We comprehensively searched 13 databases for relevant intervention studies. The review was conducted with service user input in accordance with Cochrane Collaboration’s guidelines. We duplicated assessment of inclusion, data extraction, and validity assessment, tabulating data, carrying out random effects meta-analysis and narrative synthesis. Results: 43 controlled interventions were included, disappointingly none were judged at low risk of bias. Oral nutritional supplementation studies suggested small positive short term but unclear long term effects on nutritional status. Food modification or dysphagia management studies were smaller and of low quality, providing little evidence of an improved nutritional status. Eating assistance studies provided inconsistent evidence, but studies with a strong social element around eating/drinking, although small and of low quality provided consistent suggestion of improvements in aspects of quality of life. There were few data to address stakeholders’ questions.Conclusions: We found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. People with cognitive impairment and their carers have to tackle eating problems despite this lack of evidence, so promising interventions are listed. The need remains for high quality trials tailored for people with cognitive impairment assessing robust outcomes. Systematic review registration: The systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero.

AB - Background: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking. Methods: We comprehensively searched 13 databases for relevant intervention studies. The review was conducted with service user input in accordance with Cochrane Collaboration’s guidelines. We duplicated assessment of inclusion, data extraction, and validity assessment, tabulating data, carrying out random effects meta-analysis and narrative synthesis. Results: 43 controlled interventions were included, disappointingly none were judged at low risk of bias. Oral nutritional supplementation studies suggested small positive short term but unclear long term effects on nutritional status. Food modification or dysphagia management studies were smaller and of low quality, providing little evidence of an improved nutritional status. Eating assistance studies provided inconsistent evidence, but studies with a strong social element around eating/drinking, although small and of low quality provided consistent suggestion of improvements in aspects of quality of life. There were few data to address stakeholders’ questions.Conclusions: We found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. People with cognitive impairment and their carers have to tackle eating problems despite this lack of evidence, so promising interventions are listed. The need remains for high quality trials tailored for people with cognitive impairment assessing robust outcomes. Systematic review registration: The systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero.

KW - Dementia

KW - Aged

KW - Eating

KW - Drinking

KW - Meta-analysis

KW - Diet

KW - Malnutrition

KW - Dehydration

U2 - 10.1186/s12877-016-0196-3

DO - 10.1186/s12877-016-0196-3

M3 - Article

VL - 16

JO - BMC Geriatrics

JF - BMC Geriatrics

SN - 1471-2318

M1 - 26

ER -

ID: 66354164