Non-Pharmacological Interventions For The Appetite And Eating Disorders In Patients With Dementia: A Cross-Over RCT

Abstract

Objectives: The most common appetite/ eating problems in patients with dementia (PWD) are loss or increase of appetite, loss or gain of weight, changes in eating behaviour, changes in the preferences of the food, developing specific eating behaviours, eating in an appropriate way or eating non-food items, and frequently demanding food or drinks, because they forget that they have eaten. Appetite/ eating disorder is an essential and common behavioral and psychological symptom of dementia (BPSD) that leads to poor quality of life, institutionalization, and affects the physiological function of many systems of the patient. Methods/ Design: 60 patients with dementia and appetite problems and their caregivers were included. The participants were suffering from all different types and stages of dementia. The study is a cross-over randomized controlled trial. The measurements used were: Mini Mental State Examination (MMSE), Addenbrooke’s Cognitive Examination Revised (ACE-R), Geriatric Scale of Depression (GDS), Functional Rating Scale for Symptoms in Dementia (FRSSD), and Neuropsychiatric Inventory (NPI). The three non-pharmacological interventions that were used: Physical Activity (PA), Music Therapy (MT), and Psycho-Educational Programme for the Caregivers (PEPC). Results: The most effective combination for the reduction of appetite problems was found in group 6: PEPC (structure routine in the hours that the food is served) (p=0.004), followed by MT (p=0.027), followed by PA (p=0.036). The same combination was the most effective for the reduction of caregivers’ burden, as well. Conclusions: There is a combination of non-pharmacological interventions (PEPC+MT+PA) that can effectively reduce the appetite/eating problems in PwD. The same combination is the most effective in reducing the caregivers’ burden, as well.