Data from: The association between eating difficulties and biliary sludge in the gallbladder in older adults with advanced dementia, at end of life

Objectives: In clinical settings, untreatable biliary sludge in the
gallbladder can be observed in older adults with advanced dementia. The
underlying cause of biliary sludge existence in patients with dementia is
currently unknown. Therefore, we aimed to investigate the prevalence, risk
factors, and related outcomes of biliary sludge formation in the
gallbladder of older adults with dementia Design: Cross-sectional study.
Setting: Geriatric ward of University Hospital in Japan Participants:
Inpatients aged 80 and older suffering with dementia. Measurements: We
evaluated the presence of biliary sludge by diagnostic ultrasonography and
collected data regarding patient demographic information, cognition
(mini-mental state examination [MMSE]), physical activity (Barthel Index),
oral food intake (food intake level scale [FILS]), clinical stage of
dementia (functional assessment staging [FAST] of dementia), and patient
performance status (Zubrod/ Karnofsky score). Results: Male sex, larger
gallbladder volume and calories from oral intake were significantly
associated with the presence of biliary sludge (P =.02, .02, .002,
respectively). There was a significant negative correlation between the
FAST stage and the FILS level in all patients (P <.001). More
advanced dementia and dysphagia was more likely to be found in patients
with Alzheimer disease (AD) with biliary sludge, compared to patients with
AD without biliary sludge (FAST 7a, FILS II and FAST 6c, FILS V,
respectively, P =.06, 04). A logistic regression analysis revealed that
the eating status of FILS I and II, generally called “fasting or
anorexia”, was a significant risk factor for forming biliary sludge in
older adults with dementia (P =.031, odds ratio: 5.25, 95% confidence
interval: 1.16-23.72). Conclusions: Fasting status may be associated with
the existence of biliary sludge in older adults with dementia. Therefore,
supportive care for eating might be an important solution to comfortable
end-of-life care for older adults with advanced dementia.