Gastrostomies in dementia: bad practice or bad evidence?

摘要

Tube feeding in dementia remains controversial as evidencednby recent responses to the Royal College ofnPhysicians (RCP) report on oral feeding [1]. Criticisms ofnnon-oral feeding are based on a failure to show a favourablenoutcome [2] or to lengthen survival [3, 4], a worsening ofnprognosis [5] and a higher mortality rate in hospitalised patientsn[6]. When dysphagia become severe, nasogastric tubesnare often the first recommendation [1], with gastrostomiesninserted once the patient is well enough to tolerate the procedure.nHowever, there are many unanswered questionsnabout tube feeding in general and gastrostomies in particularnwith respect to dementia: