Objectives To investigate national trends in percutaneous endoscopic gastrostomy (PEG) tube placement for hospitalized elderly patients from 1993to 2003. Methods Retrospective analysis of patients ≥65 years of age with PEG tube placement from 1993 to 2003 from the Nationwide Inpatient Sample (NIS) database was utilized to calculate PEG placement rates per 1000 people. Results Placement of PEG tube increased by 38% in elderly patients during the study period, from 2.71 procedures during hospitalization per 1000 people to 3.75 procedures during hospitalization per 1,000 people. Placement of PEG tube in patients with Alzheimer’s dementia doubled (5%–10%) over the study period. Conclusion Over a 10-year period, PEG tube use in hospitalized elderly patients increased significantly. More importantly, approximately 1 in 10 PEG tube placements occurred in patients with dementia.

These studies suggest that there is an alteration in the morphology of the small arterioles in hypertension and aging, that may lead to reduced ability to perfuse cortical tissue. In addition, there appears to be a diminution of overall short-term cardiovascular and microvascular control.