What is associated with low food intake in older people with dementia?

Aims. The aim of this study was to investigate the risk factors of institutionalised older people for developing low food intake. Background. Eating difficulties among patients with dementia have been identified in western society and typically progress as dementia advances. Findings from previous studies reflect that low food intake or weight loss might not be a consequence of people with dementia being unable or unwilling to eat independently. Design. The study consisted of observers' training and mealtime observations. Each data collector received two days of didactic and clinical training. Observation was done for two days during lunch and dinner. Methods. Four hundred seventy-seven participants were selected from residents with dementia at nine dementia special care units in licensed long-term care facilities in northern and central Taiwan. Data were collected using the Barthel index, Mini-Mental State Examination (MMSE), and the Edinburgh Feeding Evaluation in Dementia (EdFED) scale. Results. The prevalence of low food intake at meals in residents with dementia in LTCF's was 30·7%. Eating difficulty, no feeding assistance, moderate dependence, fewer family visits, being female and older, were six independent factors associated with low food intake after controlling for all other factors. Conclusion. Nursing staff need to assess residents' feeding ability to continue to self-feed. Also, to supervise the feeding of residents with moderate dependency and provide appropriate verbal or physical assistance at meal times is recommended. Relevance to clinical practice. Constructing strategies to encourage families to visit their older relatives in institutions is recommended. © 2010 Blackwell Publishing Ltd