Feinstein Institutes study challenges the use of thick liquid diets in hospitalized patients with dementia and dysphagia
06 Mayo 2024 - 11:52AM
Business Wire
Published in the Journal of the American
Medical Association (JAMA) Internal Medicine, research finds no
mortality difference between thick or thin liquid diets
Up to 86 percent of hospitalized patients with Alzheimer’s
disease and related dementias (ADRD) have oropharyngeal dysphagia
(dysphagia), a type of swallowing dysfunction that can lead to
aspiration, pneumonia, malnutrition, intubation, and even death.
Although dysphagia diets, consisting of thick liquids, are widely
used, it is unknown whether thick liquids improve patient outcomes.
To study the effect of thick versus thin liquids – which are
assumed to be easier to consume – researchers at The Feinstein
Institutes for Medical Research published a large, retrospective
study looking at the health outcomes of over 8,000 patients in the
Journal of the American Medical Association (JAMA) Internal
Medicine.
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Feinstein Institutes’ Drs. Alex
Makhnevich (left) and Liron Sinvani (right) led the new study.
(Credit: Feinstein Institutes)
The study, conducted across 11 diverse hospitals in New York
between January 1, 2017 and September 20, 2022 aimed to determine
whether thick liquids, compared to thin liquids, are associated
with improved health outcomes in patients with ADRD and dysphagia.
Contrary to expectations, the study found no significant difference
in hospital mortality between patients receiving thick and thin
liquids. This primary outcome raises important questions about the
benefits of thick liquids for dysphagia management in hospitalized
patients with ADRD.
“When hospitalized patients with Alzheimer’s disease and related
dementias are found to have dysphagia, our go-to solution is to use
a thick liquid diet; however, there is no concrete evidence that
thick liquids improve health outcomes, and we also know that thick
liquids can lead to decreased palatability, poor oral intake,
dehydration, malnutrition, and worse quality of life,” said Liron
Sinvani, MD associate professor in the Institute of Health System
Science at the Feinstein Institutes and Donald and Barbara Zucker
School of Medicine at Hofstra/Northwell, director of the geriatric
hospitalist service at Northwell Health and senior author on the
paper.
Additionally, the study showed that while patients receiving
thick liquids were more likely to experience respiratory
complications such as pneumonia, they were less likely to be
intubated. “Given the high prevalence of dysphagia in hospitalized
patients with ADRD, along with the widespread use of thick liquids
and potential quality of life implications, our findings underscore
the urgent need for additional prospective studies to evaluate the
complex effect of thick liquids on health outcomes in this
vulnerable population,” said Alex Makhnevich, MD, assistant
professor in the Institute of Health System Science at the
Feinstein Institutes, and lead author on the paper.
“Drs. Sinvani and Makhnevich’s study advances understanding of
managing dysphagia in patients with ADRD,” said Kevin J. Tracey,
MD, president and CEO of the Feinstein Institutes and Karches
Family Distinguished Chair in Medical Research. “These results will
prompt ongoing research to guide clinical decisions that improve
patient outcomes.”
Although thick liquids are recognized for their ability to
prevent aspiration in specific patients with dysphagia, the study’s
results emphasize the necessity for further prospective studies.
These studies should integrate instrumental assessments such as
Modified Barium Swallow Studies (MBSS) to assess the influence of
thick liquids on clinical outcomes in hospitalized patients with
ADRD and dysphagia.
About the Feinstein Institutes
The Feinstein Institutes for Medical Research is the home of the
research institutes of Northwell Health, the largest health care
provider and private employer in New York State. Encompassing 50
research labs, 3,000 clinical research studies and 5,000
researchers and staff, the Feinstein Institutes raises the standard
of medical innovation through its five institutes of behavioral
science, bioelectronic medicine, cancer, health system science, and
molecular medicine. We make breakthroughs in genetics, oncology,
brain research, mental health, autoimmunity, and are the global
scientific leader in bioelectronic medicine – a new field of
science that has the potential to revolutionize medicine. For more
information about how we produce knowledge to cure disease, visit
http://feinstein.northwell.edu and follow us on LinkedIn.
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Matthew Libassi 631-793-5325 mlibassi@northwell.edu