Treatment of institutionalized older patients with PEU requires multiple interventions: Environmental measures (eg, making the dining area more attractive) Feeding assistance Changes in diet (eg, use of food enhancers and caloric supplements between meals) Treatment of depression and other underlying disorders Use of orexigenic drugs, anabolic steroids, or both The long-term use of gastrostomy tube feeding is essential for patients with severe dysphagia; its use in patients with dementia is controversial.