ESPEN guidelines on nutrition in dementia

Volkert D, Chourdakis M, Faxen-Irving G, Fruhwald T, Landi F, Suominen MH, Vandewoude M, Wirth R, Schneider SM (2015)

Publication Type: Journal article

Publication year: 2015

Journal

Clinical Nutrition Elsevier

Book Volume: 34

Pages Range: 1052-73

Journal Issue: 6

DOI: 10.1016/j.clnu.2015.09.004

Abstract

Older people suffering from dementia are at increased risk of malnutrition due to various nutritional problems, and the question arises which interventions are effective in maintaining adequate nutritional intake and nutritional status in the course of the disease. It is of further interest whether supplementation of energy and/or specific nutrients is able to prevent further cognitive decline or even correct cognitive impairment, and in which situations artificial nutritional support is justified.It is the purpose of these guidelines to cover these issues with evidence-based recommendations.The guidelines were developed by an international multidisciplinary working group in accordance with officially accepted standards. The GRADE system was used for assigning strength of evidence. Recommendations were discussed, submitted to Delphi rounds and accepted in an online survey among ESPEN members.26 recommendations for nutritional care of older persons with dementia are given. In every person with dementia, screening for malnutrition and close monitoring of body weight are recommended. In all stages of the disease, oral nutrition may be supported by provision of adequate, attractive food in a pleasant environment, by adequate nursing support and elimination of potential causes of malnutrition. Supplementation of single nutrients is not recommended unless there is a sign of deficiency. Oral nutritional supplements are recommended to improve nutritional status but not to correct cognitive impairment or prevent cognitive decline. Artificial nutrition is suggested in patients with mild or moderate dementia for a limited period of time to overcome a crisis situation with markedly insufficient oral intake, if low nutritional intake is predominantly caused by a potentially reversible condition, but not in patients with severe dementia or in the terminal phase of life.Nutritional care and support should be an integral part of dementia management. In all stages of the disease, the decision for or against nutritional interventions should be made on an individual basis after carefully balancing expected benefit and potential burden, taking the (assumed) patient will and general prognosis into account.

Authors with CRIS profile

Dorothee Volkert Professur für Klinische Ernährung im Alter Rainer Wirth Medizinische Fakultät

Involved external institutions

Aristotle University of Thessaloniki GR Greece (GR) Karolinska Institute SE Sweden (SE) Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel AT Austria (AT) Catholic University of the Sacred Heart / Università Cattolica del Sacro Cuore IT Italy (IT) Helsingin yliopisto / University of Helsinki FI Finland (FI) University of Antwerp / Universiteit Antwerpen BE Belgium (BE) Hôpital l'Archet (CHU de Nice) FR France (FR)

How to cite

APA:

Volkert, D., Chourdakis, M., Faxen-Irving, G., Fruhwald, T., Landi, F., Suominen, M.H.,... Schneider, S.M. (2015). ESPEN guidelines on nutrition in dementia. Clinical Nutrition, 34(6), 1052-73. https://dx.doi.org/10.1016/j.clnu.2015.09.004

MLA:

Volkert, Dorothee, et al. "ESPEN guidelines on nutrition in dementia." Clinical Nutrition 34.6 (2015): 1052-73.

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