Study | Design | Setting, supplement type | Number completed | Dementia stage | Dementia type | Effect on nutrition or hydration status | Effect on intake of nutrients or fluid | Quality and Other outcomes | Duration |
---|---|---|---|---|---|---|---|---|---|
ONS (including energy, protein and often other nutrients) plus usual food vs. usual food (with or without placebo ONS) | |||||||||
 Abalan 1992 France [30] | RCT | Geriatric inpatients. Proprietary ONS (‘Tonexis’) vs usual food | I = 15 C = 14 | NR | AD | N/A | → E intake | ↑ Cognitive function | 15 weeks |
 Beck 2002 Denmark [32] | RCT | Nursing home (risk of malnourishment). Home-made ONS vs usual food | I = 8 C = 8 | NR | NR | → Weight | → E intake | N/A | 2 months |
 Carlsson 2009 Sweden [34] | CCT (BA) | Group-living facilities for people with dementia. Drinkable yogurt | 13 | NR | Mixed | ↓ Weight | → E intake → Fluid intake | → Functional status | 6 months |
 Carver 1995 UK [36] | RCT | Psychiatric hospital/elderly ward (under-weight). Proprietary ONS (‘Fortisip’) vs placebo | I = 20 C = 20 | NR | NR | ↑ Weight ↑* BMI →TSF ↑ MAMC | N/A | N/A | 12 weeks |
 de Sousa 2012 Portugal [37] | RCT | Psychiatric hospital, geriatric unit, mild dementia patients (malnourished). ONS vs usual care & advice | I = 20 C = 15 | Mild | AD | ↑ Weight  ↑ BMI | ↓ Nutritional risk | → Functional status → Cognitive function | 3 weeks |
 Faxen-Irving 2002 Sweden [38] | CCT | Group-living for people with dementia. ONS & diet advice vs usual care | I = 21 C = 12 | Mixed | Mixed | ↑a Weight ↑a BMI ↑‡ TSF → AMC | N/A | → ADL ↓ Cognitive function | 5 months |
RCT | Nursing home (long term rehabilitation centre). ONS vs placebo | I = 24 C = 26 | NR | NR | ↑ Weight ↑ BMI → MAMA → TBW | → E intake → Fluid intake | →Functional status | 10 weeks | |
RCT | Residential care facilities. Protein-enriched drink (+/− exercise) vs placebo drink (+/− exercise) | I = 96 C = 95 | NR | NR | → Weight → ICW | N/A | → Balance → Gait → Lower limb strength | 3 months | |
 Gregorio 2003 Spain [40] | RCT | Nursing home residents with AD. Proprietary ONS (‘Nutrison’) vs usual food | IG = 24 C = 74 | Mod | AD | ↑* BMI | ↓* Nutritional risk | N/A | 12 months |
 Lauque 2000 France [44] | RCT | Nursing homes (risk of malnourishment). Proprietary ONS (Clinutren, Nestle) vs usual food | I = 19 C = 22 | NR | NR | → Weight → BMI | ↑ E intake ↑ Protein intake | → Grip strength | 2 months |
 Lauque 2004 France [45] | RCT | Geriatric wards & day centres (risk of malnourishment). Proprietary ONS (Clinutren) vs usual food | I = 37 C = 43 | Mod | NR | ↑ Weight ↑ BMI | ↑ E intake ↓ Nutritional risk | →ADL → Cognitive function → Eating behaviour | 3 months |
 Manders 2009 Netherlands [46] | RCT | Nursing homes. ONS vs placebo | I = 78 C = 33 | NR | NR | ↑ Weight ↑ Calf circumference | N/A | → Functional status → Grip strength → Cognitive status | 24 weeks |
 Navrátilová 2007 Czech Republic [47] | RCT | Institutionalised residents with AD (type of institution unclear). Proprietary ONS (‘Nutridrink’) vs usual food | I = 50 C = 50 | NR | AD | → Weight → BMI | ↑†E intake ↑†Protein intake | ↑ Cognitive function | 1 year |
 Pivi 2011 Brazil [55] | RCT | Setting unclear. Proprietary supplement (Ensure with FOS®) vs usual care | I = 26 C = 27 | Mild-severe | AD | ↑* Weight ↑* BMI ↑* AMC ↑* AC  → TSF | N/A | N/A | 6 months |
 Planas 2004 Spain [48] | CCT (BA)♣ | Dementia care day centre. ONS +/− micronutrients | I = 23 C = 21 | Mild | AD | → BMI ↑ MAMC ↑ TSF | ↑ E intake | → Cognitive function | 6 months |
 Simmons 2010a USA [50] | RCT | Long-term care facilities, type unclear. Between meal nutritional supplements vs. usual care | I = 18 C = 20 | NR | NR | → Weight | → E intake | ↑ Costs & staff time | 6 weeks |
 Souvenir I | CCT (BA)♣ | AD Treatment Centres. Proprietary ONS (Souvenaid) vs isocaloric placebo | I = 98 C = 97 | Mild | AD | → BMI | N/A | → Cognitive function → QoL | 12 & 24 weeks |
RCT | Nursing home (risk of malnutrition). ONS vs usual care | I = 45 C = 42 | Mod-severe | NR | ↑ Weight → BMI ↑ UAC ↑ Calf circumference | → E intake → Protein intake → Nutritional risk | → Cognitive function → ADL | 12 weeks | |
 Wouters-Wesseling 2002 Netherlands [53] | RCT | Nursing homes, residents with dementia. ONS vs placebo | I = 19 C = 16 | NR | Mixed | ↑ Weight → BMI | N/A | → Functional status | 12 weeks |
 Wouters-Wesseling 2006 Netherlands [52] | RCT | Psychogeriatric nursing homes (with acute infection). ONS vs usual care | I = 18 C = 16 | NR | NR | → Weight → TST → AMC | → E intake | → Functional status | 5 weeks |
RCT | Dementia units within a nursing home. ONS vs high carbohydrate meals | I = 15 C = 19 | NR | AD | ↑ Weight | ↑ E intake ↑ Protein intake | N/A | 3 weeks | |
Fruit juice plus normal food vs control drink plus normal food | |||||||||
 Krikorian 2010a USA [42] | RCT | Community-dwelling. Grape juice vs placebo | I = 5 C = 7 | MCI | N/A | →* Weight →* Waist | N/A | ↑ Learning, → Spatial awareness, → Recall | 12 weeks |
 Krikorian 2010b USA [43] | CCT | Community-dwelling. Blueberry juice vs placebo | I = 9 C = 7 | MCI | N/A | →* Weight →* Waist | N/A | ? Cognition, ? Spatial awareness | 12 weeks |
 Krikorian 2012 USA [41] | RCT | Community-dwelling. Grape juice vs placebo | I = 10 C = 11 | MCI | N/A | → Weight → Waist | N/A | NR | 16 weeks |
Additional snacks between meals plus usual food vs usual food | |||||||||
 Simmons 2010b USA [50] | RCT | Long-term care facilities. Between meal snacks & assistance vs usual care | I = 25 C = 20 | NR | NR | → Weight | → E intake | ↑ Costs ↑ Staff time | 6 weeks |
Multicomponent interventions including ONS | |||||||||
RCT | Elderly nursing home residents. ONS, Gratin diet, exercise, oral care vs usual care | I = 54 C = 55 | NR | NR | ↑ Weight ↑ BMI | → E intake ↑ Protein intake | → Cognitive performance → ADL | 11 weeks | |
 Boffelli 2004 Italy [33] | CCT (BA) | Malnourished residents of dementia unit. Individualised diet including mealtime assistance, environmental modification and ONS if required | 19 | Severe | Mixed | → Weight → BMI ↑ Serum albumin | N/A | N/A | 18 months |