認知症高齢者に対する経口栄養補助食：メタ解析

認知症高齢者に対する経口栄養補助食（ONS）の系統的レビューとメタ解析の論文を紹介します。

Victoria J. Allen, Lisa Methven, Margot A. Gosney. Use of nutritional complete supplements in older adults with dementia: systematic review and meta-analysis of clinical outcomes. Clinical Nutrition, http://dx.doi.org/10.1016/j.clnu.2013.03.015

結果ですが、認知症高齢者に対する経口栄養補助食（ONS）投与で、平均6.5カ月後のフォローで、体重増加（3.54kg）、BMI増加（0.92）、認知機能改善（MMSEで1.6点、ただし症例数少ない）が得られました。これより認知症へのONS投与は有用という結論です。

認知症の体重増加にONSが有用ということは以前の系統的レビューでも言われていましたが、今回は認知機能改善まで出ました。ただ、この解釈には十分な注意が必要だと思います。生命予後改善までは得られていませんので、今後のさらなる研究も必要かと思います。

Abstract

Background

& Aims: Malnutrition is prevalent in people diagnosed with dementia however ensuring adequate oral intake within this group is often problematic. It is important to determine whether providing nutritionally complete oral nutritional supplements (ONS) drinks is an effective way of improving clinical outcomes for older people with dementia. This paper systematically reviewed clinical, wellbeing and nutritional outcomes in people with long-term cognitive impairment.

Methods

The CINAHL, Medline and EMBASE databases were searched from their inception until January 2012. Reference lists of the included papers, foreign language papers and review articles obtained were manually searched.

Results

Twelve articles were included in the review containing 1076 people in the supplement groups (intervention) and 748 people in the control groups. Meta-analysis shows there was a significant improvement in weight (p=<0 .0001="" 6.5="" and="" at="" body="" cognition="" compared="" control="" follow="" given="" group.="" index="" mass="" month="" p="" supplements="" the="" to="" up="" were="" when="">

Conclusions

Providing ONS drinks has a positive effect on weight gain and cognition at follow up in older people with dementia. Additional research is required in both comparing nutritional supplements to vitamin/mineral tablets and high protein/calorie shots and clinical outcomes relevant to people with dementia.