Nutrição artificial na demência avançada: uma revisão narrativa da literatura

Abstract

Introduction: Dementia is a public health problem prevalent throughout the world. Feeding difficulties present in the advanced stage of dementia cause serious concerns among caregivers and family members, leading to greater indications for the use of artificial nutrition. Several medical entities do not recommend the use of artificial nutrition in advanced dementia, however there is controversy in the literature. Objective: Review the literature on the topic. Methodology: Narrative literature review study searching for articles published in the last ten years in the SciELO and PubMed databases. The descriptors were used: “advanced dementia”, “artificial nutrition” and “enteral nutrition” and articles available in full in Portuguese, English and Spanish were included. Articles in which the patients did not have advanced dementia were excluded. Results and discussion: 11 articles were selected from the SciELo and PubMed databases published between 2014 and 2022. There is agreement between most articles on the lack of benefits from the use of artificial nutrition in patients with advanced dementia, demonstrating that this does not increase survival, does not improve quality of life, nutritional status or the healing of pressure injuries and does not reduce the risk of aspiration and aspiration pneumonia, being associated with several harms. Conclusion: The use of artificial nutrition in patients with advanced dementia is not routinely indicated. This decision must be individualized considering the prior values of the patient and their family members and/or legal representatives in the absence of Advance Directives.