Association Between Eating Disorders and the Survival in Older Patients with Dementia: Paliative Care Unit-Based Cohort Study

The aim of our study was to identify the peculiarities of eating disorders on the survival rates of patients with dementia. The present, prospective cohort study conducted in palliative care unit and performed with ۷۷ patients admitted to our clinic in ۲۰۲۲-۲۰۲۳. The degree of dementia was assessed by standard valid MMSE, CDR and FAST scales. The presence of eating disorders was diagnosed by EdFED-Q and MNA-SF questionnaires. Eating disorders were presented in ۵۸ patients (۷۶.۳%), and dysphagia in ۳۰ (۳۹.۰%). Patients with dementia and without eating disorders were included in study group D (n=۱۹); patients with dementia and eating disorders (except dysphagia) were included in study group DE (n=۲۸); patients with dementia, eating disorders and dysphagia were included in study group DED (n=۳۰). Eating disorders (according to the MNA-SF scale) were more significantly manifested in group DED than in groups D and DE (p<۰.۰۰۱, in both cases), and in group DE vs. group D (p=۰.۰۰۳). Survival analysis showed that survival rate in group D was ۵۲.۶%, in group DE –۱۷.۹%, and in group DED – ۳.۳%. Hazard ratio (HR) of bad outcome in group DED compared to group D was significant - HR=۷.۳۲ (p<۰.۰۰۱); HR between groups DED and DE was also significant - HR=۲.۶۷ (p<۰.۰۰۱); HR of bad outcome between groups DE and D was also significant - HR=۳.۱۴ (p=۰.۰۰۱). It was concluded that mortality rate was significantly increased if eating disorders were manifested; they became significantly higher if dysphagia was presented.

Keywords:

Alzheimer’s disease , Dysphagia , mortality , Vascular dementia