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Experience of percutaneous endoscopic gastrostomy in Alzheimer's disease and senile dementia of the Alzheimer's type cases
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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 

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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