Incidence and predictors of eating disability among nursing home residents with middle-stage dementia

Background & aims: Inability to feed oneself is documented in people with Alzheimer disease, however little research has differentiated between eating disability due to dementia and eating disability due to factors other than dementia that may be remediable (i.e. 'excess disability'). The study aim was to estimate the incidence and identify the predictors of eating disability due to dementia and to excess disability. Method: In a one year, prospective cohort study of 120 nursing homes residents with middle-stage dementia, ability to eat was monitored fortnightly. Potential predictors of disability were assessed using survival analysis. Results: The estimated incidence of eating disability was 40.8% (95% confidence interval (CI): 32.7%-50.2%). Half of this was attributed to causes other than dementia (23.6%; 95% CI: 16.6%-33.0%). Predictors of eating disability included more advanced dementia (hazard ratio (HR): 2.6,95% CI: 1.4 to 4.8), more comorbidities (HR: 2.4; 95% CI: 1.3 to 4.3), and less supportive environments (HR: 2.0; 95% CI: 1.1 to 3.6). There were no statistically significant predictors of excess disability. Conclusions: Approximately half of the eating disability was not due to dementia. Eating disability may be minimized by treating comorbidities and creating supportive social and physical nursing home environments. (C) 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.