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| Experience of percutaneous endoscopic gastrostomy
in Alzheimer's disease and senile dementia
of the Alzheimer's type cases |
Jiro KANIE*, Hiroyasu AKATSU, Takayuki YAMAMOTO**,
Hiroshi SHIMOKATA***, Akihisa IGUCHI*
* Department of Geriatrics, Nagoya University
School of Medicine.
** Department of Internal Medicine, Sawarabi-kai
Fukushimura Hospital.
*** Department of Epidemiology, National
Institute for Longevity Sciences.
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| NEUROBIOLOGY OF AGING 1998; 19(4S): 21 |
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Purpose: Percutaneous endoscopic gastrostomy (PEG)
in Alzheimer's disease (AD) and senile dementia
Alzheimer's type (SDAT) cases were reviewed
to assess its usefulness and complications.
Methods: From September, 1992 to December, 1997, PEGs
were performed in 106 patients with AD or
SDAT (male: 76, female: 30, average age 81.0
years old). All patients were advanced dementia
cases more than Stage II in dementia stage
classification by Kosaka, and became indication
for PEG because of inability of oral intake.
Nutrition of the patients had been maintained
by nasogastric tube (73 cases), intravenous
hyperalimentation(21 cases) or oral intake
(12 cases).
Results: There were 34 cases with minor complications,
local skin infection (10 cases), aspiration
pneumonia (6 cases), increase of vomiting
(5 cases) and inability to exchange PEG tubes
(5 cases). One case of general peritonitis
was observed as a major complication. Whereas,
63 patients (59.4%) had benefits of increased
performance states as improvement of their
physical activities and increase verbal expression,
and consequently, 42 patients (51.2%) became
restraint-free, 19 patients (23.2%) became
restraints-minimally required after the PEG
procedures among the 82 patients who initially
required strict restraints. Although we performed
the PEG for the failure of oral intake, 14
patients became to be able to intake food
orally, and four patients became to live
without PEG tube feeding.
Conclusion: The complications of PEG were not rare. However,
PEG have more advantages than other methods
of nutrition, especially in cases with dementia,
to decrease their pains, to improve their
quality of life, and the care of demented
patients would be much easier. PEG is the
most excellent methods of nutrition in AD
or SDAT cases, and should be used widely.
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