Plain language summary
Dementia is a chronic condition characterised as a decline in cognitive functioning that leads to dependence in the performance of daily activities, including nutritional sufficiency. As the dis-ease progresses, eating and drinking may become more difficult. The aim of this study was to investigate the effects of oral nutrition supplements (ONS) on nutritional intake and clinical outcomes in older persons with dementia. This study is a systemic review which included ten studies of which 9 where experimental studies (n=6 RCTs; n=3 non RCTs) based on patients with dementia who were undernourished. Results indicate that ONS improved daily intake of energy and protein, compliance was high, and more persons met the recommended nutrition intake. In fact, intervention with ONS improved nutritional status; however, no effects on cognitive or functional outcomes were reported. Authors conclude that there is the need for a more comprehensive intervention plan for people with cognitive impairments that addresses the individual nutritional challenges in order to systematically meet nutritional needs.
Abstract
OBJECTIVE Persons with dementia are at risk of malnutrition, evidenced by low dietary intake, which has consequences for nutritional status, activity of daily living and disease progression. The effects of oral nutrition supplements (ONS) on nutritional intake, nutritional status, and cognitive and physical outcomes in older persons with dementia were evaluated. METHODS PubMed, Medline, Embase, CINAHL and the Cochrane Central Register of Controlled Trials were searched in December 2017, and this was repeated in May 2019. The Preferred Reporting Items for Systematic Reviews and Analysis (PRISMA) checklist was used. Papers were considered if they presented experimental clinical trials using oral nutritional supplements to persons diagnosed with dementia, including Alzheimer's disease and mild cognitive impairment, and conducted in hospitals, nursing homes or homes. RESULTS We included ten articles reporting nine clinical trials. A total of 407 persons with dementia were included, of whom 228 used ONS for 7 to 180 days. Nutritional intake improved by 201 to 600 kcal/day. Energy intake from ordinary foods was not affected, thus ONS improved the persons daily intake of energy and protein. Body weight, muscle mass, and nutritional biomarkers in blood improved in the intervention groups compared with the control groups. No effects on cognition or physical outcomes were observed. CONCLUSION ONS increases the intake of energy and protein and improves nutritional status in persons with dementia; however, RCTs with longer intervention periods are needed to investigate the impact on cognitive and functional outcomes.
Methodological quality
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