Projects per year
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’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.
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.
Original language | English |
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Article number | 26 |
Journal | BMC Geriatrics |
Volume | 16 |
DOIs | |
Publication status | Published - 22 Jan 2016 |
Keywords
- Dementia
- Aged
- Eating
- Drinking
- Meta-analysis
- Diet
- Malnutrition
- Dehydration
Profiles
-
Diane Bunn
- School of Health Sciences - Associate Professor of Nursing Research
- Lifespan Health - Member
- Water Security Research Centre - Member
- Volunteering and Health and Social Care - Member
- UEA Hydrate Group - Member
- Health Promotion - Member
Person: Research Group Member, Research Centre Member, Academic, Teaching & Research
-
Chris Fox
- Norwich Medical School - Honorary Professor
- Institute for Volunteering Research - Member
- Norwich Epidemiology Centre - Member
- Mental Health - Member
Person: Honorary, Research Group Member, Research Centre Member
-
Lee Hooper
- Norwich Medical School - Reader
- Population Health - Member
- UEA Hydrate Group - Member
- Epidemiology and Public Health - Member
- Health Services and Primary Care - Member
Person: Research Group Member, Research Centre Member, Academic, Teaching & Research
Projects
- 2 Finished
-
CLAHRC - Eating and Drinking in Dementia (linked to R22140)
Hooper, L., Fox, C., Hooper, L., Killett, A., Potter, J. & Abdelhamid, A.
National Institute for Health and Care Research
22/01/14 → 31/01/15
Project: Research
Research output
- 122 Citations (Scopus)
- 1 Article
-
Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review
Bunn, D., Abdelhamid, A., Copley, M., Cowap, V., Dickinson, A., Howe, A., Killett, A., Poland, F., Potter, J., Richardson, K., Smithard, D., Fox, C. & Hooper, L., 4 May 2016, In: BMC Geriatrics. 16, 89.Research output: Contribution to journal › Article › peer-review
Open AccessFile67 Citations (Scopus)32 Downloads (Pure)