Evaluating a brief intervention for mealtime difficulty on older adults with dementia.

Only eight participants completed all three phases, so the study cannot show how common the effect is or which residents are most likely to keep it. The intervention and outcome assessment were done by the same investigator, which can bias the results. The analysis relied on visual inspection and phase means, which are subjective and can be affected by unusual scores. The design did not randomize phases and did not compare participants with a separate control group, so it cannot rule out other changes in circumstances. The study was done in two private nursing homes in one city, and care there was provided largely by care assistants with one registered nurse on shift, so it may not apply to other settings. It measured behavioural mealtime difficulty, not swallowing. The economic analysis reports cost per calorie, but the authors could not compare it with the cost of malnutrition, so cost-effectiveness is unknown.

The authors declared no conflicts of interest. The study was funded by the University of Hull.

Do not conclude that spaced retrieval alone is a proven, lasting treatment. The intervention also included quiet one-to-one sessions, familiar food and repeated mealtime practice, and the study cannot separate these components. Only eight participants completed all phases, and the effect was not sustained in four after it stopped.