Mikako Takahashi, Shuichirou Kitahara, Tatsuya Mikami, Junya Kobayashi, Tsuyotoshi Tsuji, Yutaka Suzuki, Michio Maruyama, Nobuyuki Uchida, Akira Horiuchi, Shuzo Shintani, Tetsushi Ogawa, Takanori Fujiki, Masato Murakami, Toshiro Kusakabe, Akihiko Murakami, Yukiko Tanaka, Takayuki Kohri, Shingo Okada, Ikuta Tanaka, Satoshi Goshi, Mitsuyoshi Urashima, Shigeru Onozawa, Ko Tahara, Masato Nakahori, Atsushi Yoshida, Tomoyuki Ohta, Makoto Shimazaki, Masashi Ijima, Hiroaki Shigoka, Satoshi Orimo, Hitoshi Suenaga, Kazuaki Jomoto, Masahiko Suzuki, Toshifumi Matsumoto, Takao Iiri, Tomoko Ogawa, Kazuhiko Kitagawa, Masami Matsumoto, Akihiro Mizuhara, Yasuhiko Ito, Izumi Ishizuka, Shinji Nishiwaki, Toshiroh Kura, Toru Ito, Shigeki Ono, Hiromi Ono, Michiaki Kudo, Tsutomu Kikuchi, Hitoshi Okano, Tsuyoshi Iwase, Naohiro Washizawa, Kazuhiro Akiyama, Koji Onishi, Masaki Izumi, Satoyoshi Yamashita, Takao Endo, Yukio Nishiguchi, and Masahiko Aoki
Background To examine the effects of percutaneous endoscopic gastrostomy (PEG) on quality of life (QOL) in patients with dementia. Methods We retrospectively included 53 Japanese community and tertiary hospitals to investigate the relationship between the newly developed PEG and consecutive dementia patients with swallowing difficulty between Jan 1st 2006 and Dec 31st 2008. We set improvements in 1) the level of independent living, 2) pneumonia, 3) peroral intake as outcome measures of QOL and explored the factors associated with these improvements. Results Till October 31st 2010, 1,353 patients with Alzheimer’s dementia (33.1%), vascular dementia (61.7%), dementia with Lewy body disease (2.0%), Pick disease (0.6%) and others were followed-up for a median of 847 days (mean 805 ± 542 days). A total of 509 deaths were observed (mortality 59%) in full-followed patients. After multivariate adjustments, improvement in the level of independent living was observed in milder dementia, or those who can live independently with someone, compared with advanced dementia, characterized by those who need care by someone: Odds Ratio (OR), 3.90, 95% confidence interval (95%CI), 1.59 - 9.39, P = 0.003. Similarly, improvement of peroral intake was noticed in milder dementia: OR, 2.69, 95%CI, 1.17 - 6.17, P = 0.02. Such significant associations were not observed in improvement of pneumonia. Conclusions These results suggest that improvement of QOL after PEG insertion may be expected more in milder dementia than in advanced dementia.