Do Feeding Tubes Work in Patients with Dementia?
A gastrostomy tube is placed in a patient to provide nutrition and hydration. Although in theory tube feeding can provide adequate nutrition in a patient with dementia, in reality this is often not the case. Because of problems with diarrhea, clogging of the tubes, and the tendency of patients with dementia to pull out the tubes, nutritional status often does not improve with the use of feeding tubes.16 Aside from maintaining nutrition, one of the primary reasons to use a feeding tube is to interrupt the cycle of eating, aspiration, and then pneumonia that is so common in patients with advanced dementia. It is now clear from multiple observational studies that feeding tubes do not prevent aspiration in patients with dementia.17 The continued risk of aspiration appears to result from reflux of gastric contents and aspiration of saliva. I am unaware of any randomized study that has compared the risk of aspiration with and without tube feeding in patients with advanced dementia. Hence, wh
