Treatment of Dysphagia in Patients with Dementia: a Systematic Review and Meta-Analysis.

Abstract

To evaluate the effect of various treatment methods on improving swallowing function in patients with dementia dysphagia. Systematic review and meta-analysis. Dementia with dysphagia. A systematic search was conducted across eight databases, including Wanfang, CNKI, VIP, Sinomed, PubMed, Cochrane, Web of Science, and Embase, from inception to November 2024. Eligible studies included randomized controlled trials (RCTs) and quasi-experimental studies assessing treatment measures for dysphagia in dementia patients. Seventeen studies met the inclusion criteria, involving 1,593 participants. The methodological quality was moderate, with substantial baseline control and outcome evaluation, but there were weaknesses in randomization, allocation concealment, and blinding. Treatment measures include behavioral intervention therapy (swallowing training), physical therapy (electrical stimulation, cervical movement), nutritional intervention therapy (diet adjustment, intermittent oral to esophageal tube feeding), and comprehensive training. The meta-analysis results showed that compared with standard care, the overall effect of various treatment methods was significant (standardized mean differences (SMD) = -0.89; 95 % CI = -1.12 ~ -0.66, P < 0.0001). Subgroup analysis showed that the intervention effect of swallowing training was better among various treatment methods. (SMD = -1.56; 95% CI: -2.17 to -0.95, P < 0.0001). Improvements were more significant in patients with mild dysphagia (SMD = -1.06; 95% CI: -1.65 to -0.48, P = 0.0003) and interventions lasting 4-6 weeks (SMD = -0.99; 95% CI: -1.36 to -0.62, P < 0.00001). Various treatment methods can effectively improve the swallowing function of patients with dementia dysphagia. It may be best to carry out 4-6 weeks of swallowing training for patients with early dementia and dysphagia. In the future, higher-quality multicenter studies will be needed for verification.