Project title

Eating and Drinking Well IN dementiA (EDWINA)

Type of research

Health Service Research- systematic review, qualitative research, development of tools for people with dementia

Background & Scientific Rationale

Increasing numbers of older adults in the UK have dementia which can result in eating and drinking difficulties, a major source of ill health and stress. People with dementia are more likely to drink insufficient fluid, more likely to be malnourished, and the risk of malnutrition increases as dementia progresses. People with dementia have ten times the risk of hospital admission for dehydration (3% of admissions) and anorexia as primary diagnoses (1% of admissions) than age-matched controls (0.3% of admissions for dehydration, 0.1% for anorexia), and admissions for abdominal pain, constipation, nausea and vomiting and bronchopneumonia are all higher for those with dementia. While systematic reviews have been carried out to assess the potential nutritional causes of dementia, none have examined the effectiveness of interventions to support people with dementia to eat and drink well.

Aim and research questions

The key aim of this project was to increase understanding of the problems around eating and drinking well for people with dementia, and the solutions that may help facilitate people living in residential care with dementia to eat and drink better. The project team systematically reviewed research from around the world and assessed the effectiveness of 56 interventions which all aimed to improve, maintain, or facilitate food or drink intake among more than 2,200 people with dementia.

Interventions tested included changing the colour of the plate, increasing exercise, waitress service, playing different types of music, singing, doing tai-chi, creating a home-like eating environment, providing nutrition supplements, and boosting the social aspect of eating.They also looked at whether better education and training for formal or informal care-givers could help, as well as behavioural interventions – such as giving encouragement for eating. The research team assessed whether these interventions improved hydration status and body weight, and whether the intervention helped older people to enjoy the experience of eating or drinking, and improved their quality of life.

Key findings and outputs

Findings published reveal that while no interventions were unequivocally successful, promising approaches focused on a holistic approach to mealtimes. The team found that eating family-style meals with care-givers, playing music, and engaging with multisensory exercise – could all help boost nutrition, hydration and quality of life among people with dementia.


  • Bunn DK., Abdelhamid A., Copley M., Cowap V., Dickinson A., Howe A., Killett A., Poland F., Potter JF., Richardson K., Smithard D., Fox C., and Hooper L. Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review. BMC Geriatrics. 2016; 16:89. doi: 10.1186/s12877-016-0256-8 (pdf)

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For further information, contact Dr Lee Hooper at

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