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Percutaneous endoscopic gastrostomy for nutritional support in dementia patients

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Abstract

Background

A link between aging, dementia and malnutrition is established and leads to poor prognosis. Endoscopic gastrostomy (PEG) is used without clear benefit on survival, nutritional status or quality of life.

Aims

This work aims to assess the effectiveness of PEG-feeding for nutritional support in patients with dementia.

Methods

We conducted an observational, longitudinal and retrospective study using records from patients with moderate-severe dementia that underwent PEG. Age, gender, dementia subtype and mortality were considered. Body mass index (BMI), serum albumin, transferrin and total cholesterol were recorded at the time of the PEG procedure (T0) and repeated after 3 months (T3). The evolution of those parameters was analysed and compared to survival.

Results

We obtained data from 46 patients (16 men/30 women) between 50 and 94 years (M = 79 years). Most had Alzheimer’s. Mean survival was 21 months. Mortality rate at 3 months was 15 %. At T0, 30 patients were undernourished according to BMI and 29, 31 and 16 patients displayed low albumin, transferrin and total cholesterol, respectively. Albumin (p < 0.01) and transferrin levels (p < 0.05) were significantly increased from T0 to T3. High albumin (r = 0.2), transferrin (r = 0.3) and cholesterol (r = 0.1) at T0 were positively correlated with longer survival.

Conclusions

Low albumin, transferrin and cholesterol were predictors of a poor survival. PEG improves low albumin and transferrin, serum markers of malnutrition and poor outcome. PEG should be considered on an individual basis in patients with moderate-severe dementia when risk of malnutrition and aspiration is present.

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Authors and Affiliations

  1. Gastroenterology Department, GENE-Enteral Feeding Team, Hospital Garcia de Orta, Almada, Portugal

    Gonçalo Nunes, Carla Adriana Santos & Jorge Fonseca

  2. Master in Economics, Nova School of Business and Economics, Lisbon, Portugal

    Carla Santos

  3. CiiEM, Centro de investigação interdisciplinar Egas Moniz, Monte da Caparica, Portugal

    Jorge Fonseca

Authors
  1. Gonçalo Nunes
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  2. Carla Adriana Santos
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  3. Carla Santos
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  4. Jorge Fonseca
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Corresponding author

Correspondence to Gonçalo Nunes.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Statement of human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Nunes, G., Santos, C.A., Santos, C. et al. Percutaneous endoscopic gastrostomy for nutritional support in dementia patients. Aging Clin Exp Res 28, 983–989 (2016). https://doi.org/10.1007/s40520-015-0485-2

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  • DOI: https://doi.org/10.1007/s40520-015-0485-2

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