Prevalence of Feeding Difficulty Among Persons Living With Dementia: A Systematic Review and Proportional...

To estimate the pooled prevalence of feeding difficulties among persons with dementia and to explore heterogeneity, including regional differences and study characteristics. Feeding difficulties, including impaired ability to feed oneself, swallowing problems, reduced appetite, and behavioral resistance to eating, are common among individuals with dementia, leading to malnutrition, and caregiver burden. Evidence on the prevalence of feeding difficulties is fragmented, with no prior meta-analysis available. Six databases were searched until April 2025 for observational studies. This systematic review and meta-analysis followed MOOSE and PRISMA guidelines with PROSPERO registration (CRD420251024333). Studies were included if they reported feeding difficulty prevalence in dementia using validated instruments or clinical observation. Two reviewers independently screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Pooled prevalence and 95% prediction intervals were calculated using a random-effects model with Freeman-Tukey double arcsine transformation. Subgroup analyses and meta-regression explored heterogeneity. Fifteen studies involving 3175 participants were included. The pooled prevalence of feeding difficulties among persons with dementia was 48% (95% PI: 38%-59%), with significant heterogeneity (I² = 97%). Prevalence was notably higher in studies conducted in Asia (59%) compared to non-Asian regions (32%). Neither publication year nor mean participant age significantly moderated prevalence estimates. Nearly half of individuals with dementia experience feeding difficulties, with particularly high prevalence in Asia. This regional disparity stresses the importance of routine assessment. High heterogeneity and inconsistent disease staging reporting call for standardized assessments and further research across dementia stages to improve care globally.