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Advanced Dementia – PEG Feeding Evidence — SCE Neurology MCQ

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ModerateNeurodegenerative DiseaseAdvanced Dementia – PEG Feeding EvidenceSCE Neurology

A 75-year-old man with Alzheimer disease develops swallowing difficulties and recurrent aspiration pneumonia. He has lost 8 kg in 6 months. His family asks about PEG feeding. What does the evidence show regarding PEG tube feeding in advanced dementia?

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Correct answer: APEG feeding does not improve survival, reduce aspiration pneumonia risk, or improve quality of life in advanced dementia

Multiple systematic reviews and guidelines (including NICE NG97 and the Cochrane review) have demonstrated that PEG tube feeding in advanced dementia does not prolong survival, does not reduce the risk of aspiration pneumonia (aspiration of oral secretions still occurs), does not improve nutritional status meaningfully, and may cause discomfort and complications (tube displacement, infection, restraint). Careful hand-feeding and comfort-focused oral care are recommended. A: Evidence does not support improved outcomes. C: It is not mandatory and may be harmful. D: It does not cure aspiration. E: Decision-making should be individualised.

Reference: NICE NG97 Dementia (2018); Sampson et al. Cochrane Review