Patients with advanced dementia with feeding problems such as poor oral intake and dysphagia (difficulty swallowing) are often fed by a nasogastric tube to reduce the risk of aspiration pneumonia and improving survival. However, a recent study by Li Ka Shing Faculty of Medicine (HKUMed) found that patients with advanced dementia who were fed by tube had no advantage in survival compared with those who were carefully fed by hand, but had a 40 percent higher risk of contracting pneumonia.
The retrospective cohort study identified 764 patients with advanced dementia considered for tube feeding due to feeding problems. The findings showed that patients initiated on careful hand feeding had a risk of pneumonia 40 percent lower than those on nasogastric tube feeding. Among patients with both behavioral eating problems and dysphagia, nasogastric tube feeding was associated with a higher risk of pneumonia than manual feeding.
