ArticleJournal of the American Geriatrics Society2024
Pre-hospitalization dysphagia and feeding tube placement in nursing home residents with advanced dementia.
Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 8 citations in OpenAlex.
- Feeding-related hospitalizations and outcomes in advanced dementia.European geriatric medicine · 2026Observational
- Age and sex adjusted adiposity estimators predict all cause and pneumonia related mortality in hospitalized older patients with severe dysphagia receiving artificial nutrition.Frontiers in nutrition · 2026Article
- Frailty Status and Dysphagia Trajectory Among Hospitalized Nursing Home Residents With Advanced Dementia.Journal of the American Medical Directors Association · 2025Article
- Behavioral Challenges and Adaptive Strategies in Providing Mealtime Care to Residents With Dementia: A Qualitative Study of Nursing Home Clinical and Administrative Staff.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Article
- Prognostic predictors of mortality among individuals with advanced dementia residing in nursing homes: a prospective cohort study.BMC geriatrics · 2025Article
- Use of Feeding Tubes Among Hospitalized Older Adults With Dementia.JAMA network open · 2025Article
- Can invasive interventions be avoided with a holistic swallowing therapy program in older patients in intensive care units: percutaneous endoscopic gastrostomy tubes or oral intake?Frontiers in neurology · 2025Article
- Feeding Modality and Longitudinal Nutritional Status in Severe Dementia: A Matched Cohort Study.American journal of Alzheimer's disease and other dementiasArticle
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDespite research demonstrating the risks of using feeding tubes in persons with advanced dementia, they continue to be placed. The natural history of dysphagia among patients with advanced dementia has not been examined. We conducted a secondary analysis of a national cohort of persons with advanced dementia staying at a nursing home stay before hospitalization to examine (1) pre-hospitalization dysphagia prevalence and (2) risk of feeding tube placement during hospitalization based on preexisting dysphagia.
methodsA retrospective cohort study consisting of all nursing home (NH) residents (≥66 years) with advanced dementia (Cognitive Function Scale score ≥2), a hospitalization between 2013-2017, and a Minimum Data Set (MDS) 3.0 assessment within 120 days before hospitalization. Pre-hospitalization dysphagia status and surgically placed feeding tube insertion during hospitalization were determined by MDS 3.0 swallowing items and ICD-9 codes, respectively. A multivariate logistic model clustering on hospital was used to examine the association of dysphagia with percutaneous endoscopic gastrostomy (PEG) feeding tube placement after adjustment for confounders.
resultsBetween 2013 and 2017, 889,983 persons with NH stay with advanced dementia (mean age: 84.5, SD: 7.5, and 63.5% female) were hospitalized. Pre-hospitalization dysphagia was documented in 5.4% (n = 47,574) and characterized by oral dysphagia (n = 21,438, 2.4%), pharyngeal dysphagia (n = 24,257, 2.7%), and general swallowing complaints/pain (n = 14,928, 1.7%). Overall, PEG feeding tubes were placed in 3529 patients (11.2%) with pre-hospitalization dysphagia, whereas 27,893 (88.8%) did not have pre-hospitalization dysphagia according to MDS 3.0 items. Feeding tube placement risk increased with the number of dysphagia items noted on the pre-hospitalization MDS (6 vs. 0 dysphagia variables: OR = 5.43, 95% CI: 3.19-9.27).
conclusionsBased on MDS 3.0 assessment, only 11% of PEG feeding tubes were inserted in persons with prior dysphagia. Future research is needed on whether this represents inadequate assessment or the impact of potentially reversible intercurrent illness resulting in feeding tube placement.
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