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Predictors of Discontinuance of Oral Feeding in Patients With Advanced Alzheimer Dementia and Aspiration Pneumonia in Japan

A Single-center, Retrospective Observational Study

Akuzawa, Nobuhiro MD, PhD*; Yoshii, Akihiro MD, PhD; Ono, Akihiro MD, PhD; Kuwako, Tomohito MD; Osaki, Takashi MD; Osawa, Sho MD; Jingu, Asuka MD; Watanabe, Satoru MD, PhD; Saito, Ryusei MD, PhD

Alzheimer Disease & Associated Disorders: May 24, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/WAD.0000000000000316
Original Article: PDF Only

Background: Difficulty with oral feeding, the most commonly observed complication of Alzheimer disease (AD) in its final stages, occurs in 86% of AD patients and may prevent achievement of oral feeding after aspiration pneumonia. However, no reliable indicators of discontinuance of oral feeding have yet been identified. We therefore aimed to identify predictors of discontinuance of oral feeding in postaspiration pneumonia patients with AD.

Materials and Methods: Relevant clinical and laboratory data of 60 patients with AD admitted to our hospital in Japan for aspiration pneumonia were retrospectively compared between oral feeding and discontinuance groups.

Results: The study groups differed in interval since diagnosis of AD, CURB-65 score, pneumonia severity index score, and proportion of patients who died (higher in the discontinuance group) and body mass index (BMI), Mini Mental State Examination (MMSE) score, and functional independence measure score (lower in the discontinuance group). According to multivariate logistic regression analysis of all identified independent variables, only CURB-65 and MMSE scores and BMI are significant predictors of discontinuance of oral feeding after aspiration pneumonia in patients with advanced AD.

Conclusions: In patients with advanced AD, discontinuance of oral feeding after aspiration pneumonia may be predicted by CURB-65 and MMSE scores and BMI.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Divisions of *General Medicine

Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan

The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

N.A.: participated in the study design, collected and analyzed the data, and drafted the manuscript. A.Y., S.W., R.S.: participated in the study design. A.O., T.K., T.O., S.O., A.J.: collected the data and helped to draft the manuscript. All authors read and approved the final manuscript.

The authors declare no conflicts of interest.

Reprints: Nobuhiro Akuzawa, MD, PhD, Division of General Medicine, National Hospital Organization Shibukawa Medical Center, 383 Shiroi, Shibukawa, Gunma 377-0280, Japan (e-mail:

Received January 25, 2019

Accepted April 2, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved