Percutaneous endoscopic gastrostomy for nutritional support in dementia patients.
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.
['Nunes|Gonçalo|G|', 'Santos|Carla Adriana|CA|', 'Santos|Carla|C|', 'Fonseca|Jorge|J|']
D000368:Aged D000369:Aged, 80 and over D015992:Body Mass Index D002784:Cholesterol D003704:Dementia D004750:Enteral Nutrition D005260:Female D005774:Gastrostomy D006801:Humans D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D009752:Nutritional Status D018529:Nutritional Support D011788:Quality of Life D012189:Retrospective Studies D012709:Serum Albumin
Gastrostomy Nutrition Dementia PEG