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Sussex Dysphagia Network

Cochrane review: Modifying the consistency of food and fluids for swallowing difficulties in dementia

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Cochrane review: Modifying the consistency of food and fluids for swallowing difficulties in dementia

Cochrane Systematic Review - Intervention. Published: 24 September 2018

Overview of this recent Cochrane review (of 2 studies). The full paper is linked from the overview page. This paper supports a holistic approach to modifying fluid for people with dementia as there may be long term negative consequences even if in the short term the risk of aspiration is reduced. In one of the studies people being given very thick drinks were safer on VF but they were more likely to develop aspiration pneumonia over the following 3 months compared to those on less thick fluid or thin fluid with a chin tuck. The authors acknowledge methodological flaws in both papers.        

Authors' conclusions

“We are uncertain about the immediate and long‐term effects of modifying the consistency of fluid for swallowing difficulties in dementia as too few studies have been completed. There may be differences in outcomes depending on the grade of thickness of fluids and the sequence of interventions trialled in videofluoroscopy for people with dementia. Clinicians should be aware that while thickening fluids may have an immediate positive effect on swallowing, the long‐term impact of thickened fluids on the health of the person with dementia should be considered. Further high‐quality clinical trials are required.”