Patients with advanced dementia frequently develop eating difficulties and
weight loss. Enteral feeding tubes are often used in this situation, yet be
nefits and risks of this therapy are unclear. We searched MEDLINE, 1966 thr
ough March 1999, to identify data about whether tube feeding in patients wi
th advanced dementia can prevent aspiration pneumonia, prolong survival, re
duce the risk of pressure sores or infections, improve function, or provide
palliation. We found no published randomized trials that compare tube feed
ing with oral feeding. We found no data to suggest that tube feeding improv
es any of these clinically important outcomes and some data to suggest that
it does not. Further, risks are substantial. The widespread practice of tu
be feeding should be carefully reconsidered, and we believe that for severe
ly demented patients the practice should be discouraged on clinical grounds
.