Abstract
Objectives
The purpose of this study was to establish the prevalence rate of feeding difficulty and to understand the factors associated with it among people with dementia.
Design
A cross-sectional design was used.
Setting
Five nursing homes in Taiwan.
Participants
Ninety-three residents with dementia were enrolled.
Measurements
Feeding difficulty was measured by The Edinburgh Feeding Evaluation in Dementia (EdFED) scale. Data included demographics, nutritional data, cognition, and independence were also collected.
Results
Residents with EdFED scores above five had significantly longer duration of dementia (56.3±27.4 vs 42.2±22.8, P<0.05), greater dependence (26.2±20.8 vs 57.4±25.7, P<0.0001), lower BMI (21.5±3.8 vs 23.2±4.6, P<0.05), and greater cognitive impairment (8.4±2.6 vs 6.4±3.3, P<0.001) than those with EdFED scores under five. Using 5 points as the EdFED cutoff score, the prevalence rate of feeding difficulties was 60.2%. Using multiple regression to examine the predictors of feeding difficulty, 35.1% of the variance was explained, with ADL, cognition and number of medications being significant (beta =.46,.23 and.19, respectively), while non-significant factors were age, gender, duration of dementia and eating time.
Conclusion
The prevalence of feeding difficulty was high among Taiwanese elderly with dementia. Training nurses or nursing assistants to notice feeding problems in order to provide adequate assistance is important for preventing malnutrition among residents with dementia in Taiwan nursing homes.
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References
Chang CC, Roberts BL. Cultural perspectives in feeding difficulty in Taiwanese elderly with dementia. J Nurs Scholarsh. 2008;40:235–240.
Wasson K, Tate H, Hayes C. Food refusal and dysphagia in older people with dementia: ethical and practical issues. Int J Palliat Nurs. 2001;7:465–471.
Hall GR. Chronic dementia: challenges in feeding a patient. J Gerontol Nurs. 1994;20:21–30.
Chang CC, Roberts BL. Feeding difficulty in older adults with dementia. J Clin Nurs. 2008;17:2266–2274.
Gilmore GC, Wenk HE, Naylor LA, Koss E. Motion perception and Alzheimer’s disease. J Gerontol. 1994;49:P52–P57.
Gilmore GC, Wenk HE, Naylor LA, Stuve TA. Motion perception and aging. Psychol Aging. 1992;7:654–660.
Kayser-Jones J, Schell E. The mealtime experience of a cognitively impaired elder: ineffective and effective strategies. J Gerontol Nurs. 1997;23:33–39.
Watson R, Manthorpe J, Stimpson A. Continuing professional development: carers and dementia. Learning from carers’ experiences: helping older people with dementia to eat and drink. Nurs Older People. 2003;14:23–28.
Watson R. Continuing professional development: eating and dementia. Eating difficulty in older people with dementia. Nurs Older People. 2002;14:21–26.
Lundquist RS, Bernens A, Olsen CG. Comorbid disease in geriatric patients: dementia and depression. Am Fam Physician. 1997;55:2687–2694, 703–4.
LeClerc CM, Wells DL. Use of a content methodology process to enhance feeding abilities threatened by ideational apraxia in people with Alzheimer’s-type dementia. Geriatr Nurs. 1998;19(5):261–267.
Lou MF, Dai YT, Huang GS, Yu PJ. Nutritional status and health outcomes for older people with dementia living in institutions. J Adv Nurs. 2007 Dec;60(5):470–477.
Suominen M, Muurinen S, Routasalo P, Soini H, Suur-Uski I, Peiponen A, et al. Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr. 2005;59:578–583.
Bartali B, Salvini S, Turrini A, Lauretani F, Russo CR, Corsi AM, et al. Age and disability affect dietary intake. J Nutr. 2003;133:2868–2873.
Feldblum I, German L, Castel H, Harman-Boehm I, Bilenko N, Eisinger M, et al. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J. 2007;6:37.
Watson R, Deary IJ. Measuring feeding difficulty in patients with dementia: multivariate analysis of feeding problems, nursing intervention and indicators of feeding difficulty. J adv nurs. 1994;20:283–287.
Lin L-C, Chang C-C. A Chinese translation of the EdFED-Q and assessment of equivalence. Alzheimer Dis Assoc Disord. 2003;17:230–235.
Lin LC, Watson R, Lee YC, Chou YC, Wu SC. Edinburgh Feeding Evaluation in Dementia (EdFED) scale: cross-cultural validation of the Chinese version. J Adv Nurs. 2008;62:116–123.
Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975;23:433–441.
Leung KF, Liu FB, Zhao L, Fang JQ, Chan K, Lin LZ. Development and validation of the Chinese Quality of Life Instrument. Health Qual Life Outcomes. 2005;3:26.
Yeh SC, Liu YY. Influence of social support on cognitive function in the elderly. BMC Health Serv Res. 2003;3:9.
Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989;42:703–709.
Watson R. The Mokken scaling procedure (MSP) applied to the measurement of feeding difficulty in elderly people with dementia. Int J Nurs Stud. 1996;33:385–393.
Watson R, Green SM, Legg L. The Edinburgh Feeding Evaluation in Dementia Scale #2 (EdFED #2): convergent and disciminant validity. Clin Eff Nurs. 2001;5:44–46.
Leslie WS, Lean ME, Woodward M, Wallace FA, Hankey CR. Unidentified undernutrition: dietary intake and anthropometric indices in a residential care home population. J Hum Nutr Diet. 2006;19:343–347.
Athlin E, Norberg A. Interaction between patients with severe dementia and their caregivers during feeding in a task-assignment versus a patient-assignment care system. Eur Nurse. 1998;3:215–227.
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Chang, C.C. Prevalence and factors associated with feeding difficulty in institutionalized elderly with dementia in Taiwan. J Nutr Health Aging 16, 258–261 (2012). https://doi.org/10.1007/s12603-011-0158-6
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DOI: https://doi.org/10.1007/s12603-011-0158-6