Does placement of a PEG tube in patients with dementia improve outcomes?

• A. Yes, it improves survival
• B. No, does not improve outcomes
• C. Yes, improves nutrition but not outcomes
• D. Data are inconclusive

Answer: (A)

In advanced dementia, placing a PEG tube does not reliably improve survival or other meaningful outcomes. Studies show that while caloric intake may increase temporarily, there is no proven extension of life or improvement in functional status, cognition, or quality of life. Moreover, tube feeding can bring additional risks—aspiration pneumonia, infections, tube dislodgement, hospitalizations, and caregiver burden—that may outweigh any potential nutritional benefit. Because goals of care in advanced dementia often focus on comfort and quality of life, the emphasis tends to be on maintaining oral intake if possible and providing palliative support rather than using a feeding tube to try to prolong life. Overall, the evidence does not support the idea that PEG feeding improves outcomes in this population.