Incidence of Resistive Behavior Adversely Affecting the Intake of Food and Fluids in Younger and Older People with Dementia

People with dementia can develop resistive behavior that adversely affects the intake of food and fluids. This behavior, including (non-)verbal refusal, such as pushing away cutlery or an assisting person, can lead to malnutrition, dehydration, and increases mortality risk. However, it is unclear how common this behavior is in residents with young-onset dementia (YOD; symptoms under age 65) and how it compares to late-onset dementia (LOD). This study investigated the incidence and characteristics of these behaviors. We conducted a prospective cohort study with a twelve-month follow-up period, including thirty-six care units comprising 424 beds in twelve nursing homes across the Netherlands. Monthly registration of the total number of residents at risk informed the denominator, and the numerator was determined by the number of incident cases. Of forty reported cases, sixteen were incident, resulting in an incidence rate of 32/1000 person-years. The incidence rate was higher in residents with YOD (45/1000 person-years) than in LOD (26/1000 person-years). In all cases, at least two symptoms were observed. In fourteen of sixteen cases there was a prioritized global care goal aimed at providing comfort care and accept persisting resistive behavior. The findings might imply that young residents are at greater risk of developing these behaviors, and professional and informal caregivers should be prepared for the occurrence of specific resistive behaviors in younger residents.