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Hernandez SG, Feldman S, Perez-Abalo M. Malnutrition, Dysphagia, Sarcopenia and Weakness in the Older Population: A Retrospective Review to Enlighten Future Directions for Health System Best Practices. Dysphagia 2024; 39:514-521. [PMID: 38078983 DOI: 10.1007/s00455-023-10636-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/24/2023] [Indexed: 05/26/2024]
Abstract
The older population is growing exponentially causing greater demands on healthcare. Malnutrition, dysphagia, sarcopenia and weakness are highly prevalent diseases in the older population. Previous research (Byun et al. in BMC Geriatr 19(356):1-7, 2019; Fujishima et al. in Geriatr Gerontol Int 19:91-97, 2019; Hernandez et al. in Nutr Hosp 32(4):1830-1836, 2015; Nagano et al. in J Nutr Health Aging 23(3):256-265.5, 2019; Nishioka et al. in Clin Nutr 36(4):1089-1096, 2017; Robinson et al. in Clin Nutr 37(4):1121-1132, 2018, https://doi.org/10.1016/j.clnu.2017.08.016 ) has shown that these disorders are frequently associated, in many cases, preventable using screenings and intervention. This study utilized the National Hospital Discharge Survey of 2008 from the National Center of Health Statistics as secondary data to examine the associations amongst these four variables as well as possible correlations with age, days of care in the acute care hospital setting and frequency of rehabilitative and nutritional interventions received by these patients. Out of 165,630 cases, a sample size of 59,029 cases ages 65 and above were filtered by the researchers for desired diagnoses and procedure codes. After this, all neurological diagnoses were filtered and excluded by the researchers, resulting in 2458 cases. Using the Chi square test of independence, findings revealed significant associations between the variables of malnutrition and dysphagia (χ2 (1) = 1882.618, p = 0.001), dysphagia and weakness (χ2 (1) = 21.069, p = 0.001) and malnutrition weakness (χ2 (1) = 88.434, p = 0.001). The point biserial correlation coefficient was calculated to examine possible associations between these four conditions and age as well as days of care. A significant negative correlation was found between malnutrition and age (rpb (2456) = - 0.043, p = 0.05). In addition, days of care were significantly correlated with malnutrition (r(2456) = 0.138, p = 0.001) and inversely significantly correlated with dysphagia (r(2456) = - 110, p = 0.001), weakness (r(2456) = - 0.060, p = 0.001) and sarcopenia (r(2456) = - 0.041, p = 0.05). Lastly, the study found a large disparity between cases that received rehabilitative and nutritional intervention and those that didn't.
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Affiliation(s)
- Samantha G Hernandez
- Human Services, Albizu University, 2173 NW 99th Ave., Doral, FL, 33172, USA.
- , Miami, USA.
| | | | - Maria Perez-Abalo
- Human Services, Albizu University, 2173 NW 99th Ave., Doral, FL, 33172, USA
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Miwa T, Hanai T, Hayashi I, Hirata S, Nishimura K, Unome S, Nakahata Y, Imai K, Shirakami Y, Suetsugua A, Takai K, Shimizu M. Dysphagia risk evaluated by the Eating Assessment Tool-10 is associated with health-related quality of life in patients with chronic liver disease. Nutrition 2024; 124:112440. [PMID: 38652977 DOI: 10.1016/j.nut.2024.112440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/14/2024] [Accepted: 03/23/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE This study aimed to reveal the prevalence and characteristics of individuals at risk of dysphagia in patients with chronic liver disease (CLD) and its association with health-related quality of life (HRQOL). METHODS This cross-sectional study included 335 outpatients with CLD. Dysphagia risk, sarcopenia risk, malnutrition risk, and HRQOL were assessed using the Eating Assessment tool-10 (EAT-10), SARC-F, Royal Free Hospital-Nutrition Prioritizing Tool (RFH-NPT), and Chronic Liver Disease Questionnaire (CLDQ), respectively. Dysphagia risk and low HRQOL were based on EAT-10 ≥3 and CLDQ overall score <5, respectively. Factors associated with dysphagia risk and low HRQOL were assessed using the logistic regression model. RESULTS Dysphagia risk and lower HRQOL were observed in 10% and 31% of the patients, respectively. Patients with dysphagia risk were older, had lower liver functional reserve, were at higher risk for sarcopenia and malnutrition, and showed lower CLDQ overall score (median, 4.41 vs. 5.69; P < 0.001) than those without. After adjustment, SARC-F (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.02-1.50; P = 0.029) and RFH-NPT (OR, 1.71; 95% CI, 1.04-2.81; P = 0.034) scores were independently associated with dysphagia risk. EAT-10 (OR, 1.17; 95% CI, 1.04-1.30; P = 0.008) and SARC-F (OR, 1.37; 95% CI, 1.18-1.59; P < 0.001) scores were also independently associated with low HRQOL. CONCLUSIONS Dysphagia risk was prevalent in approximately 10% of patients with CLD and was associated with a risk of sarcopenia and malnutrition. Furthermore, dysphagia risk was related to HRQOL in patients with CLD.
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Affiliation(s)
- Takao Miwa
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan.
| | - Tatsunori Hanai
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan; Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Itsuki Hayashi
- Department of Oral and Maxillofacial Sciences, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Sachiyo Hirata
- Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Kayoko Nishimura
- Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Shinji Unome
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Yuki Nakahata
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan; Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Kenji Imai
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Yohei Shirakami
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Atsushi Suetsugua
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Koji Takai
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan; Division for Regional Cancer Control, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Masahito Shimizu
- Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
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3
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Agnes CS, Nayak S, Devadas U. Prevalence of oropharyngeal dysphagia symptoms in community-dwelling older adults: A community survey. Indian J Gastroenterol 2023:10.1007/s12664-023-01476-z. [PMID: 38105373 DOI: 10.1007/s12664-023-01476-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/23/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Dysphagia is a common clinical condition in older adults with significant implications for health and quality of life (QOL). However, its prevalence and associated factors in the Indian community-dwelling older adults remain understudied. The present study aims at identifying the prevalence of oropharyngeal dysphagia symptoms in Indian community-dwelling older adults and identifying the age-related comorbid variables associated with an increased risk of oropharyngeal dysphagia in this population. METHODS Total 384 community-dwelling older adults (60 years of age or older) who were independent in performing daily activities were included in the present study. The Malayalam version of the Eating Assessment Tool-10 (EAT-10) questionnaire was used to assess individuals at risk for dysphagia. Additionally, they also completed a self-report questionnaire addressing age-related comorbid variables associated with an increased risk of oropharyngeal dysphagia. RESULT Using the Malayalam version of the EAT-10, the present study identified the prevalence of oropharyngeal dysphagia symptoms in 9.9% of community-dwelling older adults. Among the EAT-10 symptoms, cough while/after swallowing, difficulty swallowing solids and difficulty swallowing liquids were the most prevalent symptoms reported by participants. Increase in age and age-related comorbidities such as tooth loss, history of heart failure and digestive diseases were found to be significantly associated with the reporting of risk for dysphagia symptoms. CONCLUSION As dysphagia symptoms significantly impact the social, psychological and QOL of community-dwelling older adults, it is important to develop awareness about these symptoms among older adults, caretakers and physicians. Early detection and appropriate management of community-dwelling older adults at risk for dysphagia can contribute to better health outcomes and improved QOL.
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Affiliation(s)
- C S Agnes
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576 104, India
| | - Srikanth Nayak
- Department of Audiology and Speech-Language Pathology, Yenepoya Medical College, Yenepoya University (Deemed to Be University), Mangalore, 575 018, India
| | - Usha Devadas
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576 104, India.
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Chou KR, Huang MS, Chiu WC, Chen YH, Chen YY, Xiao Q, Yang SC. A comprehensive assessment of oral health, swallowing difficulty, and nutritional status in older nursing home residents. Sci Rep 2023; 13:19914. [PMID: 37964096 PMCID: PMC10645724 DOI: 10.1038/s41598-023-47336-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/12/2023] [Indexed: 11/16/2023] Open
Abstract
Declines in oral consumption and swallowing function are common reasons which may elevate the risk of malnutrition in the older adults. This study aimed to provide valuable information and contribute to the existing body of knowledge in this field as well as highlight the importance of a comprehensive assessment of oral health, swallowing function, and nutritional status in long-term care residents. This was a cross-sectional study. Thirty-nine participants were recruited from a nursing home. The comprehensive assessment was evaluated in participants, including oral health (Oral Health Assessment Tool (OHAT)), swallowing function (Functional Oral Intake Scale (FOIS) and Eating Assessment Tool (EAT)-10), and nutritional status (Mini Nutritional Assessment-Short Form (MNA-SF). The average age of participants was 80.4 ± 11.7 years, and 46% of these older adults were found to be at the risk of malnutrition. There was a negative correlation between the OHAT and MNA-SF scores. In addition, subjects with poor oral health (OHAT score = 5~8), oral consumption of a modified diet (FOIS score = 4~6), and reduced swallowing function (EAT-10 score ≥ 3) were more likely to be at risk of malnutrition. A comprehensive evaluation of oral health and swallowing function was closely connected with the nutritional status of older nursing home dwellers.
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Affiliation(s)
- Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Mao-Suan Huang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wan-Chun Chiu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Department of Nutrition, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsiu Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yu-Yoh Chen
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan
| | - Qian Xiao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Suh-Ching Yang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Shiota C, Kusama T, Takeuchi K, Kiuchi S, Osaka K. Oral Hypofunction and Risk of Weight Change among Independent Older Adults. Nutrients 2023; 15:4370. [PMID: 37892444 PMCID: PMC10610140 DOI: 10.3390/nu15204370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Oral health is essential for nutritional status; however, little is known about its association with weight change. This study aimed to investigate whether the risk of weight change differs according to the presence of each important component of oral hypofunction (fewer remaining teeth, low chewing efficiency, swallowing problems, and xerostomia) among independent older adults. This was a three-year follow-up cohort study based on self-reported questionnaires. The participants were independent older adults aged ≥65 from the Japan Gerontological Evaluation Study (JAGES). We used >5% weight loss/gain during follow-up as the outcome variables, and the number of remaining teeth (≥20/10-19/0-9), the presence of chewing difficulty, swallowing problems, and xerostomia (yes/no) as the exposure variables. We fitted the Poisson regression model, including possible confounders to estimate the risk ratios (RRs) and 95% confidence intervals (CIs). For weight loss, RRs were significantly higher among those with 0-9 remaining teeth (RR = 1.17; 95% CI = 1.11-1.23), chewing difficulty (RR = 1.12; 95% CI = 1.07-1.16), and xerostomia (RR = 1.11; 95% CI = 1.06-1.16), but there was no significant association with swallowing problems (RR = 1.01; 95% CI = 0.97-1.06). For weight gain, we also found similar associations with oral hypofunction. Oral hypofunction among older adults could have non-negligible health impacts on nutritional status.
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Grants
- 15H01972, 19H03861, 22K17265, 22H03299 Japan Society for the Promotion of Science
- H28-Choju-Ippan-002, 23FA1022 Health Labour Sciences Research Grant
- JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP21lk0310073, JP21dk0110037, JP22lk0310087, JP22rea522107 Japan Agency for Medical Research and Development
- OPERA, JPMJOP1831 Open Innovation Platform with Enterprises, Research Institute and Academia
- 1-4 a grant from Innovative Research Program on Suicide Countermeasures
- adopted number: 19-2-06 a grant from Sasakawa Sports Foundation, a grant from Japan Health Promotion & Fitness Foundation, a grant from Chiba Foundation for Health Promotion & Disease Prevention, the 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation
- 29-42, 30-22,20-19, 21-20 grants from Meiji Yasuda Life Foundation of Health and Welfare and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology
- JPMJSP2114 JST SPRING
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Affiliation(s)
- Chihiro Shiota
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (C.S.); (T.K.)
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Namasivayam-MacDonald A, Lam B, Ma J, Affoo R. Prevalence, Incidence, and Predictors of Self-reported Swallowing Difficulties in Community-Dwelling Adults: A Population-Based Study from the Canadian Longitudinal Study on Aging (CLSA). Dysphagia 2023; 38:1406-1420. [PMID: 37031453 DOI: 10.1007/s00455-023-10570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/28/2023] [Indexed: 04/10/2023]
Abstract
There is a paucity of evidence from population-based studies identifying prevalence and incidence of dysphagia, as well as health and sociodemographic risk factors that may contribute to its development. As such, the current study aimed to determine prevalence, incidence, and associated predictors of dysphagia in adults. The Canadian Longitudinal Study on Aging is a nationally representative population study that follows 51,338 Canadians over 45 years of age. Biological, medical, psychological, social, lifestyle and economic data are collected. A secondary analysis of the data was conducted to determine prevalence, incidence, and the predictors of self-reported swallowing difficulty in adults between 45 and 85 years of age. Rates of swallowing difficulty by demographic risk factor, as well as lifestyle and health factors were analyzed using descriptive statistics. Associations between lifestyle and health variables with dysphagia were tested using Chi-square tests or t tests, as appropriate. Logistic regression was used to determine the predictors of self-reported swallowing difficulties. Overall prevalence of self-reported swallowing difficulties in adults over the age of 45 was 10.6% and increased to 13.7% after 3 years. Significant differences (p < 0.001) in self-reported swallowing difficulty at baseline were apparent across smoking status, requiring help to prepare meals, life satisfaction, social participation, all disease categories except dementia, number of medications, cognition, oral health status, and frailty. Incidence of dysphagia was 8.6%. Regression analyses suggested the following independent predictors of reports of swallowing difficulty: older age; non-white ethnicity; female sex; poor oral health; malnutrition; and frailty. These predictors should be carefully considered to ensure we are screening at-risk populations. Social determinants of health, such as ethnicity, must also be considered to ensure equitable care across the population.
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Affiliation(s)
- Ashwini Namasivayam-MacDonald
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada.
| | - Bonnie Lam
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Rebecca Affoo
- School of Communication Sciences and Disorders, Dalhousie University, Halifax, Canada
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Maehara T, Nishimura R, Yoshitake A, Tsukamoto M, Kadomatsu Y, Kubo Y, Okada R, Nagayoshi M, Tamura T, Hishida A, Takeuchi K, Wakai K, Naito M. Association of daily physical activity and leisure-time exercise with dysphagia risk in community-dwelling older adults: a cross-sectional study. Sci Rep 2023; 13:10893. [PMID: 37407654 DOI: 10.1038/s41598-023-37605-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/24/2023] [Indexed: 07/07/2023] Open
Abstract
This study aimed to clarify the association of daily physical activity and leisure-time exercise with the risk of dysphagia in community-dwelling Japanese older adults using a questionnaire-based survey. We analyzed 3070 participants (1657 men, 1413 women; age 66 ± 4 years [mean ± SD]) of the Shizuoka and Daiko studies within the Japanese Multi-Institutional Collaborative Cohort study. We used the Dysphagia Risk Assessment for the Community-dwelling Elderly questionnaire to assess dysphagia risk and the International Physical Activity Questionnaire to assess daily physical activity and leisure-time exercise. Logistic regression analyses were used to evaluate the independent association of the amount of physical activity and leisure-time exercise with dysphagia risk. The proportion of participants with dysphagia risk was 27.5% (n = 844) and the risk was significantly higher in women (29.8%, n = 421) than in men (25.5%, n = 423; P = 0.008). Daily physical activity was not associated with dysphagia risk. A greater amount of leisure-time exercise was associated with lower dysphagia risk (P for trend = 0.003) and individuals in the highest leisure-time exercise quartile had a significantly lower odds ratio (0.68, 95% CI 0.52-0.89) than those in the lowest quartile, even after adjusting for the covariates.
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Affiliation(s)
- Tomoko Maehara
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan
- Department of Public Oral Health, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan
| | - Rumi Nishimura
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan
| | - Akari Yoshitake
- Division of Dentistry and Oral Surgery, Japan, Community Health Care Organization, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, 745-0822, Japan
| | - Mineko Tsukamoto
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yuka Kadomatsu
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan.
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Leira J, Maseda A, Lorenzo-López L, Cibeira N, López-López R, Lodeiro L, Millán-Calenti JC. Dysphagia and its association with other health-related risk factors in institutionalized older people: A systematic review. Arch Gerontol Geriatr 2023; 110:104991. [PMID: 36906939 DOI: 10.1016/j.archger.2023.104991] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Dysphagia is considered a geriatric syndrome that is characterized by inability to or difficulty in safely and effectively forming or moving the food bolus toward the esophagus. This pathology is very common and affects approximately 50% of institutionalized older people. Dysphagia is often accompanied by high nutritional, functional, social, and emotional risks. This relationship implies a higher rate of morbidity, disability, dependence, and mortality in this population. This review is aimed at studying the relationship between dysphagia and different health-related risk factors in institutionalized older people. METHOD We conducted a systematic review. The bibliographic search was performed in the Web of Science, Medline, and Scopus databases. Data extraction and methodological quality were evaluated by two independent researchers. RESULTS Twenty-nine studies met the inclusion and exclusion criteria. A clear relationship between the development and progression of dysphagia and a high nutritional, cognitive, functional, social, and emotional risk in institutionalized older adults was found. CONCLUSIONS There is an important relationship between these health conditions that shows the need for research and new approaches to considerations such as their prevention and treatment as well as the design of protocols and procedures that will help reduce the percentage of morbidity, disability, dependence, and mortality in older people.
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Affiliation(s)
- Julia Leira
- Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071 A Coruña, Spain.
| | - Ana Maseda
- Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071 A Coruña, Spain.
| | - Laura Lorenzo-López
- Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071 A Coruña, Spain.
| | - Nuria Cibeira
- Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071 A Coruña, Spain.
| | - Rocío López-López
- Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071 A Coruña, Spain.
| | - Leire Lodeiro
- Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071 A Coruña, Spain.
| | - José C Millán-Calenti
- Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071 A Coruña, Spain.
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Calles-Sánchez F, Pardal-Refoyo JL. Prevalencia de la disfagia orofaríngea en pacientes adultos. Revisión sistemática y metanálisis. REVISTA ORL 2023. [DOI: 10.14201/orl.29490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Introducción y objetivo: La disfagia orofaríngea es un síntoma clínico de alta prevalencia, caracterizado por la dificultad en la deglución, que presenta diversos factores etiológicos. Su tratamiento se realiza de manera multidisciplinar, incluyendo diversos profesionales de ciencias de la salud. El objetivo es conocer la prevalencia de la disfagia orofaríngea en pacientes adultos.
Método: Se realizó una búsqueda bibliográfica de estudios relativos a la prevalencia de disfagia orofaríngea en pacientes adultos. El cribado y la selección de estudios se realizó a través del método Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Se realizó un análisis estadístico de las variables consideradas relevantes para el estudio.
Resultados: Un total de 29 estudios fueron seleccionados. La prevalencia total de la disfagia se presentó con una probabilidad de p = 0.39, en un intervalo de confianza de (IC 95% 0.303 – 0.476).
Discusión: Existe asociación o correlación entre la disfagia y diversos estados clínicos o patologías del paciente. Se ha encontrado una relación directa entre la prevalencia de la disfagia y una edad avanzada.
Conclusiones: La disfagia orofaríngea se presentó con una alta prevalencia según los estudios seleccionados. Las enfermedades neurológicas, la malnutrición y la neumonía fueron los principales estados comórbidos en los pacientes con disfagia. La función de enfermería permanece prácticamente ausente en los estudios seleccionados.
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10
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Nishioka S, Wakabayashi H. Interaction between malnutrition and physical disability in older adults: is there a malnutrition-disability cycle? Nutr Rev 2023; 81:191-205. [PMID: 35831980 DOI: 10.1093/nutrit/nuac047] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Malnutrition and physical disability are urgent issues in super-aging societies and the 2 phenomena are closely linked in older adults. Both conditions have common underlying causes, including physiological changes due to aging and burdens imposed by disease or injury. Accordingly, a concept of the malnutrition-disability cycle was generated and a comprehensive literature search was performed. There was insufficient evidence to prove an interrelationship between malnutrition and physical disabilities, because of the study design and poor quality, among other factors. However, some evidence exists for the interaction between low body mass index and swallowing disorders, and the effects of some malnutrition and disability components. This review provides the rationale for this interaction, the concept of a malnutrition-disability cycle is proposed, and the available evidence is critically appraise.
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Affiliation(s)
- Shinta Nishioka
- is with the Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki City, Nagasaki, Japan
| | - Hidetaka Wakabayashi
- is with the Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
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Iwai K, Azuma T, Yonenaga T, Nomura T, Sugiura I, Inagawa Y, Matsumoto Y, Nakashima S, Abe Y, Tomofuji T. Relationship between Oral Function and Support/Care-Need Certification in Japanese Older People Aged ≥ 75 Years: A Three-Year Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16959. [PMID: 36554840 PMCID: PMC9779451 DOI: 10.3390/ijerph192416959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
The aim was to examine the relationships between oral functions and support/care-need certification in older people aged ≥ 75 years using the National Health Insurance (NHI) database system and data from Kani City, Gifu, Japan. In total, 732 older Japanese people aged ≥ 75 years who did not have support/care-need certification and underwent dental check-ups in Kani City in 2017 were followed up until 2020. Chewing state, tongue and lip function, and swallowing function were assessed by a self-administered questionnaire, an oral diadochokinesis test, and a repetitive saliva-swallowing test, respectively. The presence or absence of systemic diseases and of support/care-need certification was based on data collected by the NHI database. At follow up, 121 (17%) participants had support/care-need certification. The participants with support/care-need certification included more women (p < 0.001) and older people (p < 0.001); and had more hypertension (p = 0.003), musculoskeletal disorders (p < 0.001), pneumonia (p = 0.044), poor chewing state (p < 0.001), and poor swallowing function (p = 0.003) than those without support/care-need certification. Furthermore, the presence of support/care-need certification at follow up was associated with sex (woman: odds ratio [OR], 2.120; 95% confidence interval [CI], 1.354 to 3.317), age (OR, 1.203; CI, 1.139 to 1.270), chewing state (poor: OR, 2.534; CI, 1.409 to 4.557), and swallowing function (poor: OR, 2.372; CI, 1.248 to 4.510) at baseline. However, tongue and lip function were not associated with support/care-need certification. The results indicate that older Japanese people aged ≥ 75 years with a poor chewing state and poor swallowing function at baseline had a higher risk for support/care-need certification after three years.
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Affiliation(s)
- Komei Iwai
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Tetsuji Azuma
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Takatoshi Yonenaga
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
| | - Taketsugu Nomura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Iwane Sugiura
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yujo Inagawa
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yusuke Matsumoto
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Seiji Nakashima
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Yoshikazu Abe
- Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Japan
| | - Takaaki Tomofuji
- Department of Community Oral Health, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho 501-0296, Japan
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Yang RY, Yang AY, Chen YC, Lee SD, Lee SH, Chen JW. Association between Dysphagia and Frailty in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14091812. [PMID: 35565784 PMCID: PMC9105461 DOI: 10.3390/nu14091812] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 12/23/2022] Open
Abstract
Background: Increasing bodies of epidemiological evidence indicate potential associations between dysphagia and the risk of frailty in older adults. We hypothesized that older adults with symptoms of dysphagia might have a higher prevalence of frailty or prefrailty than those without dysphagia. Methods: We systematically searched the PubMed, Embase, and Cochrane Library databases for relevant studies published through 20 April 2022. Cross-sectional and longitudinal studies that examined the associations between dysphagia and the existence of frailty or prefrailty in community-dwelling, facility-dwelling, or hospitalized adults aged 50 years or older were synthesized. The Newcastle–Ottawa Scale was used to evaluate study quality. Results: The meta-analysis comprised 12 cohorts, including 5,503,543 non-frailty participants and 735,303 cases of frailty or prefrailty. Random-effect meta-analysis demonstrated a significant association between dysphagia and the risk of frailty and prefrailty (OR, 3.24; 95% CI, 2.51–4.20). In addition, we observed consistent results across the subgroups and heterogeneity assessments. Conclusions: We propose including dysphagia assessment as a critical factor in the cumulative deficit model for identifying frailty in older adults. Understanding dysphagia and the potential role of nutritional supplements in older adults may lead to improved strategies for preventing, delaying, or mitigating frailty.
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Affiliation(s)
- Ru-Yung Yang
- Graduate Institute of Business Administration, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
| | - An-Yun Yang
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City 23148, Taiwan;
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
| | - Yong-Chen Chen
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Shyh-Dye Lee
- Fu Jen Affiliated Clinics, Fu Jen Catholic University Hospital, New Taipei City 242062, Taiwan;
- Graduate Program of Long-Term (Custodial) Care, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Shao-Huai Lee
- Department of Oral Hygiene and Healthcare, Cardinal Tien Junior College of Healthcare and Management, New Taipei City 23143, Taiwan;
| | - Jeng-Wen Chen
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City 23148, Taiwan;
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan;
- Department of Medical Education and Research, Cardinal Tien Hospital, New Taipei City 23148, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, National Taiwan University Hospital, Taipei 100225, Taiwan
- Correspondence:
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Swallowing difficulty in the older adults: presbyphagia or dysphagia with sarcopenia? Int J Rehabil Res 2021; 44:336-342. [PMID: 34545853 DOI: 10.1097/mrr.0000000000000494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Oropharyngeal dysphagia is an important cause of mortality and morbidity in older adults. It has been reported in the literature that 11-68% of older adults experience swallowing difficulties. This study aimed to investigate the presence of dysphagia in older adults, whether this dysphagia is related to age (presbyphagia) or sarcopenia by comparing it with adults. Two hundred twenty-five patients were included in this cross-sectional study. The participants were divided into two groups by age as 'adults' and 'older adults'. Sarcopenia, dysphagia and malnutrition evaluations were performed. Older adult and adult groups were compared in terms of malnutrition, dysphagia and sarcopenia. The number of patients with dysphagia was significantly higher (P = 0.007) in the older adults. In older adults, all sarcopenic evaluation parameters were found significantly lower than adults (P < 0.05). The number of older adults with malnutrition was significantly lower in patients with normal swallowing (P < 0.05). The swallowing difficulty can be detected in older adults even if it does not cause any complaint. While most swallowing disorders may be due to age-related changes, about a third may be accompanied by sarcopenia.
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14
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Sella-Weiss O. Association between swallowing function, malnutrition and frailty in community dwelling older people. Clin Nutr ESPEN 2021; 45:476-485. [PMID: 34620358 DOI: 10.1016/j.clnesp.2021.06.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS Swallowing function decreases with age and impacts nutritional state and frailty. The aim of the study was to test the relationship between swallowing function, dysphagia, frailty, malnutrition and depression in community dwelling older participants. METHODS Community dwelling older participants (n = 180), were enrolled (74 men aged 75.9 ± 7.8, 65-91 years, and 107 women aged 75.9 ± 8.0, 65-95 years). Swallowing function was assessed by the Test of Mastication and Swallowing Solids (TOMASS) and the Timed Water Swallow Test (TWST). Dysphagia was identified using Hebrew 10-Item Eating Assessment Tool (H-EAT-10). Frailty was assessed by grip strength and the FRAIL Questionnaire. The Mini Nutritional Assessment - Short Form (MNA-SF) was used to identify nutritional status. Depression was screened with the Geriatric Depression Scale - Short Form (GDS-SF). RESULTS 18.3% of the participants had a score of 3 or above in H-EAT-10, indicating suspected dysphagia. 17.8% of the participants were malnourished or at risk of malnutrition, and 48.3% were defined as frail or pre-frail. The odds of being malnourished/at risk of malnutrition were 3 times greater in those with suspected dysphagia. The odds of being frail/pre-frail were also 3 times greater in those with suspected dysphagia. Moreover, suspected dysphagia and frail/pre-frail health status coincided in 69.7% of participants. Participants that were malnourished/at risk of malnutrition required more masticatory cycles (p < .05) and more time (p < .05) to eat a cracker and drink 150 mL of water (p < .05), and had reduced swallowing capacity (volume/sec) in the TWST (p < .05) than those who were at normal nutritional statues. Similar results were found for frail/pre-frail participants versus robust health status. A decrease in grip strength was associated with increased (worse) frailty score, decreased nutritional score, decreased chewing function in TOMASS and decreased water drinking function in TWST (p < .05). MNA-SF score, age, GDS-SF score and EAT-10 were the best predictors of FRAIL score. CONCLUSION A simple multi-dimensional screen should be employed by trained allied health professionals, nurses and their assistants to improve early identification and early referral to relevant health providers in order to provide preventive intervention for dysphagia, nutrition, frailty and depression.
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Affiliation(s)
- Oshrat Sella-Weiss
- Department of Communication Sciences and Disorders, University of Haifa, Israel; Department of Communication Disorders, Ono Academic Collage, Israel.
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15
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Reyes-Torres CA, Castillo-Martínez L, Ramos-Vázquez AG, Chávez-Moreno DV, Serralde-Zúñiga AE. A low phase angle determined by bioelectrical impedance analysis is associated with oropharyngeal dysphagia among institutionalized older adults. Rev Assoc Med Bras (1992) 2021; 67:1161-1166. [DOI: 10.1590/1806-9282.20210578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/14/2021] [Indexed: 11/21/2022] Open
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Hasegawa Y, Yoshida M, Sato A, Fujimoto Y, Minematsu T, Sugama J, Sanada H. A change in temporal muscle thickness is correlated with past energy adequacy in bedridden older adults: a prospective cohort study. BMC Geriatr 2021; 21:182. [PMID: 33722195 PMCID: PMC7962248 DOI: 10.1186/s12877-021-02086-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Energy inadequacy has a great impact on health outcomes in older adult patients; however, it is difficult to evaluate energy adequacy in these patients, especially in home-care settings. We recently reported that temporal muscle thickness can be an indicator of nutritional status. The present study aims to examine whether a change in temporal muscle thickness is directly correlated with energy adequacy and, if so, to determine the cutoff value of a change in temporal muscle thickness to detect energy inadequacy. Methods A prospective cohort study was conducted from September 2015 to June 2016 in two hospitals in Japan, and included bedridden older adult patients aged ≥65 years. Temporal muscle thickness was measured using ultrasonography. Energy intake was estimated by photographic diet records. Total energy expenditure (TEE) was estimated by multiplying basal energy expenditure calculated using the Harris– Benedict equation by activity and stress factors. Energy adequacy was then calculated by dividing TEE by energy intake. Pearson’s correlation coefficient was used to examine the relationship between percentage change in temporal muscle thickness and energy adequacy. Multiple logistic regression analysis was conducted to determine the direct relationship between percentage change in temporal muscle thickness and moderate energy inadequacy (energy adequacy< 75%). Receiver operating characteristic (ROC) analysis was performed to determine the cutoff point for percentage change in temporal muscle thickness to detect moderate energy inadequacy. Results Forty-eight patients were analyzed (mean age 84.4 ± 7.8 years; 54.2% were women). The percentage change in muscle thickness was significantly correlated with energy adequacy (r = 0.733, p < 0.001). ROC analysis identified a percentage change in temporal muscle thickness of − 3.6% as the optimal cutoff point for detecting moderate energy inadequacy. Percentage change in muscle thickness was independently correlated with energy inadequacy after adjusting for age, sex, and masticatory status (AOR 0.281, 95% CI 0.125–0.635). Conclusions Changes in temporal muscle thickness are directly correlated with energy adequacy and can indicate moderate energy inadequacy in bedridden older adults. These results suggest the assessment of changes in temporal muscle thickness could be useful for guiding nutritional care in older adult patients in home-care settings.
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Affiliation(s)
- Yoko Hasegawa
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Clinical Nutrition Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, 2-1 Seiryoumachi, Aoba-ku, Sendai city, Miyagi, 980-8575, Japan
| | - Aya Sato
- Department of Gerontological Nursing, Kawasaki City College of Nursing, 4-30-1 Ogura, Saiwai-ku, Kawasaki city, Kanagawa, 212-0054, Japan
| | - Yumiko Fujimoto
- Department of Gerontological Nursing, School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, Wakayama city, Wakayama, 641-0011, Japan
| | - Takeo Minematsu
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Junko Sugama
- Institute for Frontier Science Initiative, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa city, Ishikawa, 920-0942, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Hirata A, Ishizaka M, Sawaya Y, Shiba T, Urano T. [Relationship between the swallowing function, nutritional status, and sarcopenia in elderly outpatients]. Nihon Ronen Igakkai Zasshi 2021; 58:134-142. [PMID: 33627550 DOI: 10.3143/geriatrics.58.134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE It is important to prevent sarcopenia in community-dwelling elderly adults. Thus, we investigated the relationship between the swallowing function, nutritional status, and physical function in elderly outpatients. METHODS A total of 90 elderly outpatients (77.2±8.3 years) participated in the study. The investigation items included the Seirei dysphagia screening questionnaire, 20 masticable foods questionnaire, tongue pressure, grip strength, the skeletal muscle mass index (SMI), the questionnaire for sarcopenia screening (SARC-F), and the Mini Nutritional Assessment-Short Form (MNA-SF). The odds ratio for the swallowing function and six items was determined by a logistic regression analysis. RESULTS About 83.3% of the participants were at risk of dysphagia. The questions that detected the symptom in ≥30% of the participants were, "Do you cough during a meal?", "Have you become slower at eating?", and "Has it become more difficult to eat hard food?". The 20 masticable foods questionnaire, SARC-F, and MNA-SF were correlated with the Seirei dysphagia screening questionnaire. The results of the logistic regression analysis indicated that SARC-F was a significant predictor for a loss of the swallowing function. CONCLUSION Because elderly outpatients have a decreased oral function, including chewing, they are at an increased risk of dysphagia. This study suggested that the swallowing function in elderly outpatients is related to the chewing ability, nutritional status, and sarcopenia. The swallowing function can thus be used to detect sarcopenia in elderly outpatients at an early stage and is important for preventing dysphagia.
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Affiliation(s)
- Aya Hirata
- Department of Speech and Hearing Sciences, School of Health Science, International University of Health and Welfare
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare.,Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en"
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en"
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for Elderly "Maronie-en".,Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare
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Nishida T, Yamabe K, Honda S. The Influence of Dysphagia on Nutritional and Frailty Status among Community-Dwelling Older Adults. Nutrients 2021; 13:nu13020512. [PMID: 33557341 PMCID: PMC7915146 DOI: 10.3390/nu13020512] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 12/13/2022] Open
Abstract
Malnutrition is a core symptom of the frailty cycle in older adults. The purpose of this study was to investigate whether dysphagia influences nutrition or frailty status in community-dwelling older adults. The study participants were 320 Japanese community-dwelling older adults aged ≥65 years. All participants completed a questionnaire survey that included items on age, sex, family structure, self-rated health, nutritional and frailty status, and swallowing function. Nutritional status was categorized as malnourished, at risk of malnutrition, and well-nourished based on the Mini Nutrition Assessment-Short Form. The participants were then classified into a malnutrition (malnourished/at risk) or a well-nourished group (well-nourished). Frailty was assessed using the Cardiovascular Health Study criteria. The participants were then divided into a frailty (frail/pre-frail) or a non-frailty group (robust). Dysphagia was screened using the 10-item Eating Assessment Tool. Multiple logistic regression analysis was conducted to determine whether dysphagia was associated with nutritional or frailty status. The results revealed that dysphagia influenced both nutrition (odds ratio [OR]: 4.0; 95% confidence interval [CI]: 1.9-8.2) and frailty status (OR: 2.3; 95% CI: 1.0-5.2); therefore, the swallowing function would be an important factor for community-dwelling older adults on frailty prevention programs.
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Affiliation(s)
- Takahiro Nishida
- Sasebo-Yoshii Community Comprehensive Support Center, Sasebo 859-6305, Japan;
- Department of Public Health Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8520, Japan
| | | | - Sumihisa Honda
- Department of Public Health Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8520, Japan
- Correspondence: ; Tel.: +81-95-819-7945
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Kurosu A, Osman F, Daggett S, Peña-Chávez R, Thompson A, Myers SM, VanKampen P, Koenig SS, Ciucci M, Mahoney J, Rogus-Pulia N. Factors Associated with Self-Reported Dysphagia in Older Adults Receiving Meal Support. J Nutr Health Aging 2021; 25:1145-1153. [PMID: 34866141 PMCID: PMC8653989 DOI: 10.1007/s12603-021-1700-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Dysphagia is common in older adults. However, there are no current estimates of dysphagia in community-dwelling older adults those receiving meal support. It is unknown whether dysphagia is associated with other measures of physical function (activities of daily living [ADL] ability or nutrition status). The study purposes were to determine the prevalence of self-reported dysphagia and to identify factors associated with self-reported dysphagia in community-dwelling older adults receiving meal support. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS 476 community-dwelling older adults (78.5±0.51 years) across five Elder Nutrition Program meal services in Wisconsin participated in the study. MEASUREMENTS Data were collected through administration of validated ADL and nutrition questionnaires (nutritional status, functional status with ADLs, chewing ability, dental conditions, and prior diagnoses of dysphagia, pneumonia, and dementia). For self-reported dysphagia, the validated 10-item eating assessment tool (EAT-10) was used. RESULTS The prevalence of self-reported dysphagia (EAT-10 score of ≥ 3) was 20.4%. Multivariate logistic regression results indicated that poor nutritional status (OR=3.1, p=0.04), difficulty chewing (OR=2.2, p=0.03), prior dysphagia diagnosis (OR=34.8, p<0.001), prior pneumonia diagnosis (OR=2.1, p=0.04), and meal service site (OR=2.68, p=0.02) were associated with self-reported dysphagia. CONCLUSION Approximately one in five community-dwelling older adults receiving meal support had self-reported dysphagia. Increased risk for poor nutrition, reduced chewing ability, prior dysphagia and pneumonia diagnosis, and meal service site were identified as factors associated with dysphagia on the EAT-10. Results highlight the need for further studies across more sites to identify dysphagia risk indicators in community-dwelling older adults receiving meal support state-wide.
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Affiliation(s)
- A Kurosu
- Nicole Rogus-Pulia, Division of Otolaryngology- Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA,
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20
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Nakayama E, Tohara H, Sato M, Abe K, Kimura M, Watanabe M, Iida M, Ueda K. Relationship between oral intake level and oral health assessment tool scores in the convalescent ward. J Oral Sci 2020; 63:79-82. [PMID: 33281145 DOI: 10.2334/josnusd.20-0414] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE To examine the relationship between oral intake function and oral health status in convalescent inpatients. METHODS Subjects were 222 patients admitted to a convalescent hospital between 1 January and 30 June 2018. Investigation items were age, sex, causative disease, body mass index, functional oral intake scale (FOIS), functional independence measure, occlusal contact, assistance with oral cleaning, and oral health assessment tool (OHAT) scores. Multiple regression analysis was performed with FOIS as the dependent variable, and investigation items were related to FOIS as independent variables. RESULTS Results of multiple regression analysis for all patients suggested that saliva and denture scores were significantly associated with FOIS. However, analysis excluding non-oral feeding patients did not show a significant association between FOIS and OHAT scores. CONCLUSION The results of this study suggest that oral health status is associated with oral intake function. In addition, the oral health status of inpatients may be strongly related to whether or not they are eating orally. Therefore, it is necessary to take good care of oral health in non-oral feeding patients in the convalescent ward.
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Affiliation(s)
- Enri Nakayama
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry.,Shin-yachiyo Hospital
| | - Haruka Tohara
- Shin-yachiyo Hospital.,Dysphagia Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Mitsuyasu Sato
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Kimiko Abe
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Masanori Kimura
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Mao Watanabe
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Masato Iida
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
| | - Koichiro Ueda
- Department of Dysphagia Rehabilitation, Nihon University School of Dentistry
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Miyoshi S, Saito A, Shigeishi H, Ohta K, Sugiyama M. Relationship between oral and physical function and length of participation in long-term care prevention programs in community-dwelling older Japanese women. Eur Geriatr Med 2020; 12:387-395. [PMID: 33145741 DOI: 10.1007/s41999-020-00424-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/16/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The present study aimed to clarify the relationship between community-dwelling older women's participation period in community-based exercise programs and their oral and physical functioning. METHODS From May to September 2019, we recruited 205 older women (mean age: 77.6 ± 5.5 years) who had joined weekly long-term care prevention programs such as community-based exercise programs that included oral and physical exercises, in Hiroshima Prefecture, Japan. Physical function was evaluated using a handgrip strength test, a Timed Up & Go test, a one-leg standing test, and a 30-s chair stand test. Tongue pressure, oral diadochokinesis, and Dysphagia Risk Assessment for the Community-dwelling Elderly were measured to evaluate oral functioning. After adjusting for clinical factors (i.e., age, BMI, hypertension, diabetes, stroke, heart disease, joint disease, osteoporosis, remaining teeth, denture use, oral wetness, history of dental examinations in the last year, use of interdental brush and/or dental floss), we compared the oral and physical function parameters of participants from varying program engagement periods using propensity score matching. RESULTS A significant increase in mean handgrip strength was found in people who had been participating for ≥ 5 years compared with those who had been participating for < 5 years (p = 0.01). Furthermore, repetition of the monosyllable/ka/was significantly greater for people in the ≥ 5 years group compared with those in the < 5 years group (p = 0.03). CONCLUSION Long-term participation in an exercise program is positively associated with handgrip strength and tongue motor function in independent older women.
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Affiliation(s)
- Sanae Miyoshi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.,Takehara-Toyota Dental Hygienists' Association, Hiroshima, Japan
| | - Ayumi Saito
- Oral Health Sciences Major, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
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Ambagtsheer RC, Beilby J, Seiboth C, Dent E. Prevalence and associations of frailty in residents of Australian aged care facilities: findings from a retrospective cohort study. Aging Clin Exp Res 2020; 32:1849-1856. [PMID: 31686388 DOI: 10.1007/s40520-019-01379-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Studies conducted among older people have shown that frailty is a common condition associated with an array of adverse outcomes. The aims of this study were to identify the prevalence and associations of frailty in older people residing in several aged care facilities located in Queensland, Australia. METHODS The database used for this study was drawn from the Aged Care Funding Instrument (ACFI) database of an Australian aged care provider, and contained data from ten aged care facilities in Queensland, Australia. A modification of an eFI originally developed by Clegg and colleagues and based on Rockwood's Frailty Index (FI) of cumulative deficits was used to identify frailty. RESULTS In total, 592 participants aged 75 years and over were included in the study (66.6% female). Median (IQR) age was 88.0 (9.0) years. Frailty prevalence among the sample was 43.6%, with 46.3% pre-frail and 10.1% not frail. In a multivariate logistic regression analysis incorporating three different models, frailty was significantly associated with three ACFI domains (Nutrition, Depression and Complex Health Care), along with facility size, consistently across two models. In the third model, frailty was also significantly associated with arthritis, diabetes, hypertension, osteoporosis and vision problems, along with male gender. CONCLUSION There is a need to develop frailty identification and management programs as part of standard care pathways for older adults residing in aged care facilities. Aged care facilities should consider regular frailty screening in residential aged care residents, along with interventions addressing specific issues such as dysphagia and depression.
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Efficacy of Mealtime Interventions for Malnutrition and Oral Intake in Persons With Dementia: A Systematic Review. Alzheimer Dis Assoc Disord 2020; 34:366-379. [PMID: 32530831 DOI: 10.1097/wad.0000000000000387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Malnutrition and weight loss are highly prevalent in persons with Alzheimer's disease and related dementias. Oral intake is an important interventional target for addressing these nutritional consequences. However, the efficacy of interventions remains poorly understood as prior syntheses have failed to examine the impact of intervention approaches on malnutrition and hypothesized mechanisms of action in persons with dementia. This review aimed to determine the efficacy of mealtime interventions to improve oral intake and nutritional outcomes in persons with dementia. Four databases yielded 1712 studies, resulting in 32 studies that met inclusion criteria. Studies included education, environmental modifications, feeding, oral supplementation, and other pharmacologic/ecopsychological interventions. While the majority of studies reported statistically significant improvements in at least 1 nutritional outcome, study design and outcome measures were heterogenous with many lacking adequate statistical power or blinding. Collectively, we found moderate evidence to suggest the efficacy of oral supplementation, and preliminary evidence to suggest that feeding interventions, education, and environmental modifications may confer improvements. Findings clarify the state of existing evidence regarding various interventional strategies for improving malnutrition in persons with dementia. While some approaches are promising, adequately powered and rigorously designed multidimensional intervention trials are needed to inform clinical decision-making in real-world contexts.
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24
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Miyoshi S, Saito A, Shigeishi H, Sugiyama M. Association of physical performance with oral function in older women participating in community-based health exercise programs. Clin Exp Dent Res 2020; 6:311-317. [PMID: 32558316 PMCID: PMC7301392 DOI: 10.1002/cre2.277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to clarify the relationship between physical performance and oral function in older women participating in community-based physical and oral exercise programs. MATERIAL AND METHODS We included 163 older women (mean age: 77.4 ± 8.6 years) who participated in weekly health programs in Takehara City, Hiroshima Prefecture, Japan, from August to December 2018. Physical fitness was assessed using a handgrip strength test, a timed up and go test, a one-leg standing time with eyes open test, and a 30-s chair stand test (CS-30). Tongue pressure, oral diadochokinesis, and dysphagia risk assessment for the community-dwelling elderly were used to assess oral function. RESULTS Participants were divided into women aged 65-74 years (younger group) and those aged ≥75 years (older group). There was no significant difference in oral function measures between the groups. A significant correlation was found between CS-30 and oral diadochokinesis for /pa/, /ta/, and /ka/ (Spearman's rank correlation; /pa/: r = .234, p = .009; /ta/: r = .299, p = .001; and /ka/: r = .283, p = .002) in the older group. Multivariable analysis revealed a significant positive relationship between CS-30 and /ta/ repetition in the older group (p = .016). CONCLUSIONS Oral function (i.e., tongue motor function) may be associated with physical performance (i.e., lower leg muscle strength) in women aged ≥75 years. Further study is necessary to clarify sex differences in oral function deterioration.
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Affiliation(s)
- Sanae Miyoshi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
- Takehara‐Toyota Dental Hygienists' AssociationHiroshimaJapan
| | - Ayumi Saito
- Oral Health Sciences, Graduate School of Biomedical & Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
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Nishida T, Yamabe K, Ide Y, Honda S. Utility of the Eating Assessment Tool-10 (EAT-10) in Evaluating Self-Reported Dysphagia Associated with Oral Frailty in Japanese Community-Dwelling Older People. J Nutr Health Aging 2020; 24:3-8. [PMID: 31886801 DOI: 10.1007/s12603-019-1256-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of the present study was to verify the associations between dysphagia as screened by the Eating Assessment Tool-10 (EAT-10) and indicators in the 100-mL water swallowing test (WST) or medical history among community-dwelling older people. STUDY DESIGN A cross-sectional study. SETTING AND PARTICIPANTS The study participants were 202 community-dwelling older Japanese adults aged ≥65 years. MEASUREMENTS We investigated the participants' basic attributes, including age, sex, body mass index, medical history (cerebrovascular disease, respiratory disease: chronic obstructive pulmonary disease [COPD], and history of pneumonia within the previous year), and number of prescribed medications. Dysphagia assessment was performed using the EAT-10 and the 100-mL WST as subjective and objective examinations, respectively. The 100-mL WST used four indicators (SC: swallowing capacity, VS: volume per swallow, TS: time per swallow, and choking signs). Patients with and without dysphagia according to the EAT-10 were divided into two groups according to a cutoff score of 3, and the two groups were then compared in terms of their characteristics including medical history and 100-mL WST indicators. A multiple logistic regression model was used to determine whether the indicators of the 100-mL WST or medical history were independently associated with dysphagia in the EAT-10. RESULTS The multiple logistic regression analysis revealed that dysphagia in the EAT-10 was independently associated with male sex (odds ratio [OR] = 2.78; 95% confidence interval [CI] = 0.98-7.90), COPD (OR = 14.68; 95% CI = 3.14-68.85), and VS and TS in the 100-mL WST (OR = 0.85; 95% CI = 0.80-0.90 and OR = 3.03; 95% CI = 1.78-5.16, respectively). CONCLUSIONS Our results revealed that the EAT-10 was independently associated with the 100-mL WST and respiratory disease. We propose that swallowing rehabilitation incorporating respiratory training could be effective for older people screened using the EAT-10.
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Affiliation(s)
- T Nishida
- Sumihisa Honda, Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan, TEL.: +81-95-819-7945, FAX.: +81-95-819-7907, E-mail:
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Kim D, Lee KE. Nutrition Care Management Practices for In-Patients with Dysphagia in Korean Clinical Settings. Clin Nutr Res 2019; 8:272-283. [PMID: 31720253 PMCID: PMC6826057 DOI: 10.7762/cnr.2019.8.4.272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/18/2019] [Accepted: 10/20/2019] [Indexed: 11/20/2022] Open
Abstract
This study aimed to examine nutrition care management for in-patients with dysphagia and to evaluate knowledge on nutrition care related to dysphagia among dietitians in clinical settings. A total of 554 questionnaires were distributed to dietitians at hospitals located in Seoul and Gyeonggi Province in Korea, and 147 responses were used for data analysis after excluding responses with significant missing data. Study participants worked at general hospitals (37.2%), long-term care hospitals (24.3%), hospitals (19.2%), and tertiary hospitals (11.5%). Prior education and training related to dysphagia was received by 69.9% of the respondents. The percentage of hospitals that had diet guidelines for dysphagia was 68.0%. Dysphagia diets of 2 levels and 3 levels were provided in 55.1% and 34.7% of the hospitals, respectively. Overall 74.7% of the dietitians responded that they provided information on dysphagia diets to in-patients and caregivers, but only 45.7% of dietitians did so in the long-term care hospitals. Among the respondents who used commercial thickening agents, 77.2% used only one type of commercial thickening agent. Patients or caregivers (75.7%) or nurses (34.5%) were reported to modify viscosity of liquid. Dietitians showed low levels of knowledge on nutrition care related to dysphagia (a mean of 5.14 based on possible scores from 0 to 10 points). To promote nutritional consumption and prevent malnutrition and aspiration, hospitals need the standardized diet guidelines, and dietitians should improve their expertise in nutritional care for patients with dysphagia.
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Affiliation(s)
- Dasom Kim
- Major of Food and Nutrition, Seoul Women's University, Seoul 01797, Korea
| | - Kyung-Eun Lee
- Major of Food and Nutrition, Seoul Women's University, Seoul 01797, Korea
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27
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Ruiz Brunner MDLM, Cieri ME, Rodríguez Marco MP, Cuestas E. The photographic atlas of Spanish food consistency: a new tool for the treatment of dysphagia. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2019; 111:858-861. [PMID: 31595755 DOI: 10.17235/reed.2019.6305/2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION dysphagia requires texture-modified foods and thickened liquids, which is difficult to explain to patients and caregivers. METHODS an atlas has been developed and validated to explain the consistencies using the Likert scale questionnaire and the Delphi survey. The agreement and reliability of the tool were evaluated, with a minimum of 80%. The atlas was developed in Spanish. RESULTS an agreement of 93.3% (95% CI: 63.7-100%) was obtained during the evaluation and a value of 97.5% and a Kappa index of 0.96 (95% CI: 0.93-0.99; p = 0.016] were obtained during the validation processes. CONCLUSION the atlas is a new valid tool that can be used by health professionals.
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Affiliation(s)
| | - María Elisabeth Cieri
- Instituto de investigaciones en Ciencias de la Sal, Universidad Nacional de Córdoba, Argentinien
| | | | - Eduardo Cuestas
- Instituto de investigaciones en Ciencias de la Sal, Universidad Nacional de Córdoba, Argentinien
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Poda GG, Hsu CY, Rau HH, Chao JCJ. Impact of socio-demographic factors, lifestyle and health status on nutritional status among the elderly in Taiwan. Nutr Res Pract 2019; 13:222-229. [PMID: 31214290 PMCID: PMC6548706 DOI: 10.4162/nrp.2019.13.3.222] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/OBJECTIVES Aging is an imperative problem for many countries in this century, and presents several challenges for the maintenance of good nutritional status. This study aims to assess the impact of socio-demographic factors, lifestyle and health status on the nutritional status among the elderly in Taiwan. SUBJECTS/METHODS A cross-sectional study was carried out in Taiwan. Data were obtained from the Mei Jau Health Management Institution, which is a private health evaluation provider with multiple health screening centers in Taiwan and Asia. This study included 7947 adults aged 65 years or above. The data were extracted between 2001 to 2010. Nutritional status was assessed using anthropometric data, biochemical data and dietary intake information. RESULTS Among the 7947 participants with mean age of 70.1 (SD = 4.5) years, 20.2%, 6.6%, 10.5% and 52.5% experienced underweight, protein malnutrition, anemia and inadequate dietary intake in the past month, respectively. Age was negatively correlated with body weight (r = -0.19, P = 0.02), body mass index (r = -0.41, P < 0.001), albumin level (r = -0.93, P < 0.001) and hemoglobin level (r = -0.30, P = 0.008). Age above 70 years, gender, unmarried status, retirement, lack of education, low family income, smoking, alcohol drinking, sleep duration of 6-8 hours, vegetarian diet, multiple medications, comorbidity and dysphagia were positively associated with malnutrition in older adults. CONCLUSIONS Underweight and inadequate dietary intake are prevalent among the elderly in Taiwan. Vegetarian diet, multiple medications, comorbidity, dysphagia and lifestyle factors such as smoking, alcohol drinking and sleep duration of 6-8 hours are risk factors for undernutrition in older adults.
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Affiliation(s)
- Ghislain G Poda
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Ministry of Health, Avenue of Burkina, Ouagadougou 7035, Burkina Faso
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, 365 Ming-Te Road, Peitou District, Taipei 112, Taiwan.,Master Program in Global Health and Development, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan
| | - Hsiao-Hsien Rau
- Joint Commission of Taiwan, 5F, No. 31, Sec. 2, Sanmin Rd., Banqiao Dist., New Taipei City 220, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Master Program in Global Health and Development, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan
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29
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Cheng YM, Ping CC, Ho CS, Lan SJ, Hsieh YP. Home-care aides’ self-perception of oral health-care provision competency for community-dwelling older people. Int Dent J 2019; 69:158-164. [DOI: 10.1111/idj.12417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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30
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Miyoshi S, Shigeishi H, Fukada E, Nosou M, Amano H, Sugiyama M. Association of Oral Function With Long-Term Participation in Community-Based Oral Exercise Programs in Older Japanese Women: A Cross-Sectional Study. J Clin Med Res 2019; 11:165-170. [PMID: 30834038 PMCID: PMC6396783 DOI: 10.14740/jocmr3664] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 10/31/2018] [Indexed: 11/24/2022] Open
Abstract
Background There are several researches demonstrating that community-based educational and exercise programs can improve oral function in older people. However, the relationship between oral function and long-term participation in health programs has not been fully elucidated. The objective of this study was to clarify the oral health status and oral function of older people (≥ 65 years) who had been participating in community-based exercise programs at community salons. Methods We enrolled 108 women (mean age: 77.6 ± 5.7 years) who participated in oral and physical exercise programs once a week at community salons in Takehara throughout May 2017. This cross-sectional pilot study was approved by the Ethical Committee of Hiroshima University and informed consent was obtained from all participants. To assess oral function, the following tests were performed: tongue pressure test, oral diadochokinesis (ODK) measurement, repetitive saliva swallowing test (RSST) and oral wetness measurement. Results A significant negative correlation was found between age and ODK or RSST (Spearman’s rank correlation; P = 0.007 and P = 0.01, respectively). The duration of participation ranged widely from 1 month to 7 years (median: 2.3 years). Although there was no significant difference between participation period and oral function, individuals who had been participating for 3 years or longer did not demonstrate a negative relationship between age and oral wetness. Furthermore, they exhibited a weaker negative relationship between age and oral function (i.e. tongue pressure, ODK and RSST) when compared with individuals who had been participating for less than 3 years. Conclusions Our results suggest that long-term participation in community salon exercise programs may suppress the deterioration of oral function in older people. Further study will be necessary to clarify the significant correlation between oral function and community-based social activities such as oral exercise.
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Affiliation(s)
- Sanae Miyoshi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.,Takehara-Toyota Dental Hygienists' Association, Hiroshima, Japan
| | - Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Eri Fukada
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Maki Nosou
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideaki Amano
- Department of Maxillofacial Functional Development, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Hasegawa Y, Yoshida M, Sato A, Fujimoto Y, Minematsu T, Sugama J, Sanada H. Temporal muscle thickness as a new indicator of nutritional status in older individuals. Geriatr Gerontol Int 2019; 19:135-140. [PMID: 30689287 DOI: 10.1111/ggi.13570] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/21/2018] [Accepted: 10/12/2018] [Indexed: 01/04/2023]
Abstract
AIM Temporal muscle wasting is subjectively evaluated during nutritional assessment of protein-energy malnutrition. However, a quantitative evaluation method has not been established. The aim was to verify the validity and reliability of temporal muscle thickness measurement in comparison with established indicators of nutritional status, such as body mass index. METHODS A cross-sectional study was carried out from September 2016 through June 2017. A total of 73 individuals aged ≥65 years were recruited from two facilities and one community walking group. Temporal muscle thickness was measured using ultrasonography. Nutritional status was assessed with anthropometric measurements and laboratory examinations. RESULTS For validity, the temporal muscle thickness showed strong correlations with muscle mass, including calf circumference (r = 0.608, P < 0.001) and arm muscle circumference (r = 0.433, P < 0.001). In contrast, no strong correlations were observed with serum protein levels, such as albumin (r = 0.324, P = 0.005), or fat mass evaluated as triceps skinfold thickness (r = 0.216, P = 0.067). Temporal muscle thickness was significantly related to body mass index after adjusting for possible confounding factors of masticatory status, age and sex (β = 0.335, P = 0.007). As for reliability, the intrarater reliability of the temporal muscle measurement was 0.99 (95% confidence interval 0.98-1.00). Bland-Altman plot analysis showed no systematic errors, and the coefficient of variation of temporal muscle thickness measurements was 2.3%. CONCLUSIONS The present study suggests that measuring a temporal muscle thickness using ultrasonography is a valid and reliable method for evaluating nutritional status. Geriatr Gerontol Int 2019; 19: 135-140.
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Affiliation(s)
- Yoko Hasegawa
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Clinical Nutrition Therapy, The University of Tokyo Hospital, Tokyo, Japan
| | - Mikako Yoshida
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Sato
- Department of Nursing Science, Faculty of Nursing and Social Welfare Science, Fukui Prefectural University, Fukui, Japan
| | - Yumiko Fujimoto
- Department of Gerontological Nursing, School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan
| | - Takeo Minematsu
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Sugama
- Institute for Frontier Science Initiative, Kanazawa University, Ishikawa, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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32
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Tagliaferri S, Lauretani F, Pelá G, Meschi T, Maggio M. The risk of dysphagia is associated with malnutrition and poor functional outcomes in a large population of outpatient older individuals. Clin Nutr 2018; 38:2684-2689. [PMID: 30583964 DOI: 10.1016/j.clnu.2018.11.022] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/03/2018] [Accepted: 11/26/2018] [Indexed: 11/29/2022]
Abstract
Oropharyngeal dysphagia (OD) is a widespread clinical condition among older adults. Although it represents a risk factor for malnutrition, dehydration and aspiration pneumonia, its assessment and contribution to functional decline is often ignored. The aim of the present study was to estimate the prevalence of OD in a large population of non-institutionalized older people and to evaluate its relationship with malnutrition and physical function. 10-item Eating Assessment Tool (EAT-10) and Mini Nutritional Assessment Short Form (MNA-SF) were used to identify the risk of dysphagia and malnutrition. Short Physical Performance Battery (SPPB) and hand-grip strength were used as functional endpoints. The relationship between risk of dysphagia and functional outcomes was tested in a multivariate regression analysis adjusted for age and sex (Model 1) and for other confounders including Mini Mental State Examination (MMSE) and polypharmacy (Model 2). Mean age of 773 subjects (61.3% female) was 81.97 years. The percentage of participants at risk of dysphagia (EAT ≥ 3) was 30.1%, 37.8% of subjects was malnourished (MNA-SF < 8), 46.2% was at risk of malnutrition (MNA-SF:8-11). EAT-10 was significantly and negatively associated to MNA-SF (β = -0.47 ± 0.06, p < 0.0001) and the strength of the relationship was attenuated but still statistically significant in the multivariate model (β = -0.28 ± 0.07, p < 0.0001). A significant and negative relationship was found between EAT-10 and SPPB and hand-grip strength in Model 1 (β = -0.25 ± 0.05, p < 0.0001) and Model 2 (β = -0.07 ± 0.03, p < 0.0001). After categorization of risk of dysphagia in two groups (at risk and not at risk), MNA-SF, SPPB and hand-grip strength were independently associated with higher risk of dysphagia (OR = 0.91, 95%CI = 0.83-0.99, p = 0.03; OR = 0.83, 95%CI = 0.77-0.89, p < 0.0001; OR = 0.96, 95%CI = 0.92-0.99, p = 0.02, respectively). In a large group of outpatient older individuals, we observed a significant negative association between risk of dysphagia and nutritional and physical performance, suggesting that the screening of OD, possibly supported by its assessment, should be implemented in the geriatric setting to potentially prevent the functional decline.
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Affiliation(s)
| | - Fulvio Lauretani
- Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, University-Hospital of Parma, Parma, Italy
| | - Giovanna Pelá
- Department of Medicine and Surgery, University of Parma, Italy
| | - Tiziana Meschi
- Department of Medicine and Surgery, University of Parma, Italy; Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, University-Hospital of Parma, Parma, Italy
| | - Marcello Maggio
- Department of Medicine and Surgery, University of Parma, Italy
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Chatindiara I, Williams V, Sycamore E, Richter M, Allen J, Wham C. Associations between nutrition risk status, body composition and physical performance among community-dwelling older adults. Aust N Z J Public Health 2018; 43:56-62. [PMID: 30457191 DOI: 10.1111/1753-6405.12848] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/01/2018] [Accepted: 10/01/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the associations between nutrition risk status, body composition and physical performance among community-dwelling older New Zealanders. METHODS This cross-sectional study enrolled 257 community-dwelling older adults (median age 79 years). Assessments included the Mini Nutritional Assessment-Short Form (MNA®-SF) for nutrition risk; the Eating Assessment Tool-10 for dysphagia risk; bioimpedance analysis for body composition (free fat mass (FFM) and percentage body fat) and gait speed for physical performance. A multiple logistics regression analysis was conducted, to determine factors associated with lower odds [OR (95% CI)] for nutrition risk. RESULTS Every yearly increase in age was associated with higher odds 1.09 (1.01-1.17) for nutrition risk. Additionally, nutrition risk was less likely to occur among participants of age <85 years 0.30 (0.11-0.79), with no dysphagia 0.29 (0.09-0.97) and those with a healthy gait speed 0.29 (0.09-0.97). Lower odds for nutrition risk were also found with increasing values of FFM index 0.51 (0.34-0.77), and percentage body fat 0.81 (0.72-0.90). Gait speed was positively correlated with FFM index (r=0.19 p<0.022), percentage body fat (r=0.23, p=0.006) and BMI (r=0.29, p<0.001). CONCLUSION Among these participants, associations between nutrition risk, body composition and physical performance were found. Implications for public health: Routine screening of nutrition risk and/or physical performance among vulnerable older adults is key towards identifying those in need of assessment and dietary intervention. Alongside strategies to encourage physical activity, this may help to slow losses of FFM and protect physical performance.
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Affiliation(s)
- Idah Chatindiara
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand
| | - Vicki Williams
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand
| | - Emily Sycamore
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand
| | - Marilize Richter
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand
| | - Jacqueline Allen
- Department of Surgery, School of Medicine, University of Auckland, New Zealand
| | - Carol Wham
- School of Sport, Exercise and Nutrition, College of Health, Massey University, New Zealand
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Sahli Z, Canner JK, Najjar O, Schneider EB, Prescott JD, Russell JO, Tufano RP, Zeiger MA, Mathur A. Association Between Age and Patient-Reported Changes in Voice and Swallowing After Thyroidectomy. Laryngoscope 2018; 129:519-524. [PMID: 30194684 DOI: 10.1002/lary.27297] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Despite intact recurrent laryngeal nerves, patient-reported voice and swallowing changes are common after thyroidectomy. The association between patient age or frailty status and these changes is unknown. The aim of this study was to evaluate the impact of age and frailty on the incidence of voice and swallowing alterations after thyroidectomy. METHODS We performed an institutional review board (IRB)-approved retrospective review of consecutive patients who underwent total thyroidectomy with intraoperative recurrent laryngeal nerve (RLN) monitoring at a single institution between January 2014 and September 2016. Patients with RLN injury were excluded. After data extraction, a modified frailty index (mFI) was calculated for each patient. The association among risk factors, including age, mFI, prior history of neck surgery, frequent voice use, presence of malignancy or gastroesophageal reflux disease, and smoking status and reported voice and/or swallowing changes was examined. RESULTS Of 924 patients undergoing thyroidectomy, 148 (16.0%) reported only changes in voice; 52 (5.6%) reported only difficulty in swallowing; and 26 (2.8%) reported changes with both voice and swallowing. On multivariate analysis, we found a significant increase in voice or swallowing alterations up to the age of 50 years (5% increased odds per year), after which these changes plateaued. We found that mFI was not associated with voice or swallowing changes. CONCLUSION Age ≥ 50 years is independently associated with the development of voice or swallowing changes after thyroidectomy, despite intact RLN. Additional prospective studies are needed to validate these findings, further define this association, and identify risk factors for developing these changes. LEVEL OF EVIDENCE 2b Laryngoscope, 129:519-524, 2019.
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Affiliation(s)
- Zeyad Sahli
- Endocrine Surgery, Department of Surgery, Baltimore, Maryland, U.S.A
| | - Joseph K Canner
- Endocrine Surgery, Department of Surgery, Baltimore, Maryland, U.S.A
| | - Omar Najjar
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Eric B Schneider
- Endocrine Surgery, Department of Surgery, Baltimore, Maryland, U.S.A
| | - Jason D Prescott
- Endocrine Surgery, Department of Surgery, Baltimore, Maryland, U.S.A
| | - Jonathon O Russell
- Head and Neck Surgery, Department of Otolaryngology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Ralph P Tufano
- Head and Neck Surgery, Department of Otolaryngology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Martha A Zeiger
- Endocrine Surgery, Department of Surgery, Baltimore, Maryland, U.S.A
| | - Aarti Mathur
- Endocrine Surgery, Department of Surgery, Baltimore, Maryland, U.S.A
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Yatabe N, Takeuchi K, Izumi M, Furuta M, Takeshita T, Shibata Y, Suma S, Kageyama S, Ganaha S, Tohara H, Yamashita Y. Decreased cognitive function is associated with dysphagia risk in nursing home older residents. Gerodontology 2018; 35:376-381. [PMID: 30028036 DOI: 10.1111/ger.12366] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 06/21/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To examine the association between cognitive function and dysphagia risk among Japanese nursing home residents. BACKGROUND Reduction in cognitive function can influence the intake of food during swallowing, and may be an aggravating factor in dysphagia. METHODS This cross-sectional study included 236 residents aged ≥60 years from eight nursing homes. Screening of dysphagia, especially aspiration risk, was conducted using the Modified Water Swallow Test, whose scores from one to three were classified as at risk of dysphagia. Cognitive function was evaluated using Mini-Mental State Examination (MMSE). Number of teeth and occlusal support were evaluated by clinical examination. The participants were stratified into dentulous and edentulous groups, because the number of teeth could influence swallowing function. The odds ratio (OR) and 95% confidence interval (CI) for dysphagia risk based on the scores of MMSE were calculated using logistic regression. Demographic characteristics, activity of daily living, comorbidities, health behaviour and occlusal support were used as covariates. RESULTS Among the 236 participants (111 dentulous participants and 125 edentulous participants) included in our analysis, 16.9% belonged to risk of dysphagia. Dentulous participants with higher scores of MMSE tended to have significantly lower odds of dysphagia risk after adjusting for covariates (OR = 0.87, 95% CI = 0.80-0.96). Despite the lack of significant differences, edentulous participants with higher score of MMSE tended to have lower odds of dysphagia risk (OR = 0.92, 95% CI = 0.83-1.00). CONCLUSION Decreased cognitive function may be an independent predictor of dysphagia among dentulous and edentulous adults.
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Affiliation(s)
- Naoko Yatabe
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kenji Takeuchi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Maya Izumi
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Michiko Furuta
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Toru Takeshita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.,OBT Research Center, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yukie Shibata
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shino Suma
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Shinya Kageyama
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Seijun Ganaha
- Aso-kizuna Dental Clinic, Kizuna-kai, Kumamoto, Japan
| | - Haruka Tohara
- Gerodontology and Oral Rehabilitation, Department of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihisa Yamashita
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Molfenter SM, Brates D, Herzberg E, Noorani M, Lazarus C. The Swallowing Profile of Healthy Aging Adults: Comparing Noninvasive Swallow Tests to Videofluoroscopic Measures of Safety and Efficiency. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1603-1612. [PMID: 29893767 PMCID: PMC6195059 DOI: 10.1044/2018_jslhr-s-17-0471] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/05/2018] [Accepted: 03/12/2018] [Indexed: 05/22/2023]
Abstract
PURPOSE It has been widely reported that a proportion of healthy, community-dwelling seniors will develop dysphagia in the absence of a known neurological, neuromuscular, or structural cause. Our objective was to test whether various feasible, noninvasive measures of swallowing could differentiate safe versus unsafe and efficient versus inefficient swallowing on videofluoroscopy (VF) in a sample of healthy seniors. METHOD VFs from 44 (21 male, 23 female) healthy community-dwelling seniors (> 65 years old) were compared with a series of feasible, noninvasive swallowing metrics: maximal tongue strength (anterior and posterior), hand grip strength, pharyngeal volume, age, body mass index, 3-oz water swallow challenge, the 10-item Eating Assessment Tool questionnaire, and the Frailty Index. The VF protocol included 9 liquid barium boluses (3 × 5 ml thin, 3 × 20 ml thin, and 3 × 5 ml nectar). Each swallow was rated (randomized and blind) for safety using the Penetration-Aspiration Scale score and for efficiency using the Normalized Residue Ratio Scale (NRRS). Participants were deemed "unsafe" if they had any single Penetration-Aspiration Scale scores ≥ 3 and "inefficient" if they had any NRRS valleculae score > 0.082 or NRRS pyriform sinus score > 0.067. Univariate analyses of variance were run for each continuous swallowing measure by swallowing safety and swallowing efficiency status. Pearson's chi-square analyses were used to compare binary outcomes by swallow safety and efficiency status. Bonferroni corrections were applied to control for multiple comparisons. RESULTS None of the swallowing measures significantly differentiated safe from unsafe swallows. Although several variables trended to distinguishing efficient from inefficient swallows (age, 10-item Eating Assessment Tool, 3-oz water swallow challenge), only one variable, pharyngeal volume, was significantly different between efficient and inefficient swallows (p = .002). CONCLUSION Our findings support the notion that larger pharyngeal volumes (measured using acoustic pharyngometry) are associated with worse swallowing efficiency, a finding we attribute to atrophy of the pharyngeal musculature in healthy aging.
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Affiliation(s)
- Sonja M. Molfenter
- Department of Communicative Sciences and Disorders, NYU Steinhardt, New York
| | - Danielle Brates
- Department of Communicative Sciences and Disorders, NYU Steinhardt, New York
| | - Erica Herzberg
- Department of Communicative Sciences and Disorders, NYU Steinhardt, New York
| | - Mehak Noorani
- Department of Communicative Sciences and Disorders, NYU Steinhardt, New York
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Andrade PA, Santos CAD, Firmino HH, Rosa CDOB. The importance of dysphagia screening and nutritional assessment in hospitalized patients. ACTA ACUST UNITED AC 2018; 16:eAO4189. [PMID: 29898087 PMCID: PMC5995555 DOI: 10.1590/s1679-45082018ao4189] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/30/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine frequency of dysphagia risk and associated factors in hospitalized patients as well as to evaluate nutritional status by using different methods and correlate the status with scores of the Eating Assessment Tool (EAT-10). METHODS This was a cross-sectional study including 909 inpatients of a philanthropic hospital. For the diagnosis of dysphagia we used an adapted and validated Brazilian version of the Eating Assessment Tool (EAT-10). The nutritional status was evaluated through the subjective global assessment, and anthropometric measurements included weight, calf and arm circumference, and knee height. The Mann-Whitney test, associations using the Pearson's χ2 and Spearman's correlation were used to verify differences between the groups. RESULTS The prevalence of dysphagia risk was 10.5%, and aging was the associated factor with this condition. Patients at risk presented lower values of arm and calf circumference, variables that correlated inversely with the Eating Assessment Tool (EAT-10) score. Malnutrition was observed in 13.2% of patients based on the subjective global assessment and in 15.2% based on the Body Mass Index. CONCLUSION Screening for dysphagia and malnutrition should be introduced in hospitals routine to avoid or minimize damages caused by dysphagia or malnutrition, especially among older people.
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Gilmore-Bykovskyi AL, Rogus-Pulia N. Temporal Associations between Caregiving Approach, Behavioral Symptoms and Observable Indicators of Aspiration in Nursing Home Residents with Dementia. J Nutr Health Aging 2018; 22:400-406. [PMID: 29484354 PMCID: PMC5830143 DOI: 10.1007/s12603-017-0943-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Dysphagia, or impaired swallowing, is common in nursing home (NH) residents with dementia and contributes to malnutrition and diminished quality of life. Dysphagia also commonly leads to aspiration or passage of food or fluids into the airway, which can result in aspiration pneumonia-a leading cause of death for people with dementia. Currently available interventions for dysphagia aim to modify the risk of aspiration events primarily by modifying diet and positioning to improve the safety of an individual's swallow. However other potentially modifiable contextual factors relevant to mealtime care within NH settings that may influence the occurrence of aspiration events, such as the nature of caregiving interactions or occurrence of dementia-related behavioral symptoms, have not been examined. To address this gap, we examined the temporal associations between caregiving approach and behavioral symptoms as antecedents to observable indicators of aspiration among nursing home (NH) residents with dementia. DESIGN Secondary analysis of coded, timed-event behavioral data from 33 video-recorded observations of mealtime interactions between NH residents with dementia and caregivers. SETTING/PARTICIPANTS Residents with dementia who required assistance with mealtime care (n=12) and nursing assistants (n=8) from Memory Care Units (MCU) in 2 Midwestern NHs. RESULTS Observable indicators of aspiration were significantly more likely to occur during or following task-centered caregiver actions than person-centered actions (12% likelihood; Yule's Q 0.89; OR 95% CI 12.70-23.75) and 15-30 seconds after a behavioral symptom (5% likelihood; Yule's Q 0.65; OR 95% CI 4.18-8.57). CONCLUSIONS These findings provide compelling preliminary evidence that caregiver approach may influence the occurrence of aspiration. Provided the urgent need for more approaches to mitigate the complications associated with dysphagia in people with dementia, even a moderate reduction in aspiration events may be clinically meaningful. Further, well-designed observational studies with individuals with well-characterized dysphagia are needed to better understand and characterize these relationships, their temporal structures and their impacts on other relevant outcomes such as eating performance and malnutrition.
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Affiliation(s)
- A L Gilmore-Bykovskyi
- Andrea Gilmore-Bykovskyi, PhD, RN, UW-Madison School of Nursing, 3173 Cooper Hall, 701 Highland Avenue, Madison, WI 53705, Phone: (608) - 262-3057, E-mail:
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Rech RS, Hugo FN, Baumgarten A, Dos Santos KW, de Goulart BNG, Hilgert JB. Development of a simplified dysphagia assessment by dentists in older persons. Community Dent Oral Epidemiol 2017; 46:218-224. [PMID: 29265407 DOI: 10.1111/cdoe.12358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 11/20/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to evaluate the diagnostic accuracy of a simplified clinical examination of swallowing by dentists and the Eating Assessment Tool (EAT-10), when compared with the diagnosis provided by a speech pathologist (gold standard). METHODS Three dentists and 1 speech pathologist clinically evaluated 265 older persons in southern Brazil, 123 were residents in long-term care and 142 were community-dwelling, all able to respond to the research protocol independently. Accuracy, sensitivity, specificity, positive and negative predictive values (+PV and -PV), and positive and negative likelihood ratios (+LR and -LR) were calculated according to standard methods. This study was approved by the Ethics Committee of the Federal University of Rio Grande do Sul. RESULTS Mean age of the participants was 73.5 (±8.9) years and most of them were women (N = 157, 59.2%). The prevalence of dysphagia as diagnosed by a speech pathologist was 45.3%. The accuracy of diagnosis was 0.84 for the clinical examination of swallowing by dentists. Furthermore, sensitivity was 0.77, specificity was 0.89, +PV was 0.85, -PV was 0.83, +LR was 7.02 and -LR was 0.25. The accuracy of EAT-10 was 0.72, the sensitivity was 0.45, specificity was 0.94, +PV was 0.87, -PV was 0.67, +LR was 8.31 and -LR was 0.57. CONCLUSIONS Simplified clinical examination of swallowing by dentists was found to be an accurate method to screen dysphagia in older persons.
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Affiliation(s)
- Rafaela Soares Rech
- Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Center of Social Dentistry Research, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alexandre Baumgarten
- Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Bárbara Niegia Garcia de Goulart
- Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Department of Health and Human Communication, Institute of Psychology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Graduate Studies Program in Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Studies Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Takeuchi K, Furuta M, Okabe Y, Suma S, Takeshita T, Akifusa S, Adachi M, Kinoshita T, Kikutani T, Yamashita Y. Swallowing disorders and 1-year functional decline in community-dwelling older adults receiving home care. J Oral Rehabil 2017; 44:982-987. [DOI: 10.1111/joor.12577] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 11/30/2022]
Affiliation(s)
- K. Takeuchi
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - M. Furuta
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - Y. Okabe
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - S. Suma
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - T. Takeshita
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
- OBT Research Center; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - S. Akifusa
- Department of Health Management; School of Oral Health Science; Kyushu Dental College; Kitakyushu Japan
| | - M. Adachi
- Itoshima Dental Association; Itoshima Japan
| | | | - T. Kikutani
- Rehabilitation Clinic for Speech and Swallowing Disorders; The Nippon Dental University Hospital; Tokyo Japan
| | - Y. Yamashita
- Section of Preventive and Public Health Dentistry; Division of Oral Health, Growth and Development; Faculty of Dental Science; Kyushu University; Fukuoka Japan
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A Significant Association of Malnutrition with Dysphagia in Acute Patients. Dysphagia 2017; 33:258-265. [DOI: 10.1007/s00455-017-9855-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 10/04/2017] [Indexed: 02/07/2023]
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Popman A, Richter M, Allen J, Wham C. High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital. Nutr Diet 2017; 75:52-58. [DOI: 10.1111/1747-0080.12385] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/03/2017] [Accepted: 08/10/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Amy Popman
- School of Food and Nutrition; Massey University; Auckland New Zealand
| | - Marilize Richter
- School of Food and Nutrition; Massey University; Auckland New Zealand
| | - Jacqueline Allen
- Department of Surgery; University of Auckland; Auckland New Zealand
| | - Carol Wham
- School of Food and Nutrition; Massey University; Auckland New Zealand
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Yamanashi H, Shimizu Y, Higashi M, Koyamatsu J, Sato S, Nagayoshi M, Kadota K, Kawashiri S, Tamai M, Takamura N, Maeda T. Validity of maximum isometric tongue pressure as a screening test for physical frailty: Cross-sectional study of Japanese community-dwelling older adults. Geriatr Gerontol Int 2017; 18:240-249. [DOI: 10.1111/ggi.13166] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 06/15/2017] [Accepted: 07/18/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Hirotomo Yamanashi
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
- Department of Clinical Medicine, Institute of Tropical Medicine; Nagasaki University; Nagasaki Japan
| | - Yuji Shimizu
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Miho Higashi
- Department of Global Health, Medicine and Welfare; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Jun Koyamatsu
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
| | - Shimpei Sato
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Mako Nagayoshi
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Koichiro Kadota
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Shinya Kawashiri
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Mami Tamai
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Takahiro Maeda
- Department of Island and Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Goto Japan
- Department of Community Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
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Wang L, Qiu XP, Ye LJ. Effects of Rood intervention and routine oral intervention on malnutrition in stroke patients with dysphagia. Shijie Huaren Xiaohua Zazhi 2017; 25:1980-1984. [DOI: 10.11569/wcjd.v25.i21.1980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To compare the effects of Rood intervention and conventional oral intervention on dysphagia in stroke patients.
METHODS Ninety-six patients with dysphagic stroke treated at our hospital from July 2011 to June 2016 were randomly divided into either an observation group to receive Rood intervention or a control group to receive routine oral intervention. The swallowing function, nutritional status and interventional effect were compared between the two groups.
RESULTS Of the 48 cases in the observation group, 29 (60.42%) had grade 1, 11 (22.92%) had grade 2, 4 (8.33%) had grade 3, 3 (6.25%) had grade 4, and 1 (2.08%) had grade 5 dysphagia. Of the 48 cases in the control group, 11 (22.92%) had grade 1, 15 (31.25%) had grade 2, 7 (14.58%) had grade 3, 9 (18.75%) had grade 4, and 6 (12.50%) had grade 5 dysphagia. There was a significant difference in the distribution of different grades between the two groups (P < 0.05). Before intervention, there was no significant difference in total protein, albumin or hemoglobin between the two groups (P > 0.05). After intervention, total protein, albumin and hemoglobin were significantly higher in the observation group than in the control group (73.69 g/L ± 2.28 g/L vs 1.54 g/L ± 3.29 g/L, 36.07 g/L ± 3.36 g/L vs 30.37 g/L ± 3.06 g/L, 122.48 g/L ± 14.13 g/L vs 113.65 g/L ± 12.86 g/L, P < 0.05). With regard to adverse events, there were six (12.50%) cases of aspiration, three (6.25%) cases of pulmonary infection, three (6.25%) cases of digestive tract complications, and two (4.17%) cases of malnutrition in the observation group, and 17 (35.42%) cases of aspiration, 12 (25.00%) cases of pulmonary infection, five (10.42%) cases of digestive tract complications, and seven (14.58%) cases of malnutrition (14.58%) in the control group.
CONCLUSION Rood intervention can effectively promote the recovery of swallowing function in stroke patients with dysphagia, improve the nutritional status of patients and reduce the risk of aspiration and malnutrition.
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Stroke in Frail Older People. Geriatrics (Basel) 2017; 2:geriatrics2030024. [PMID: 31011034 PMCID: PMC6371123 DOI: 10.3390/geriatrics2030024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/20/2017] [Accepted: 06/22/2017] [Indexed: 02/01/2023] Open
Abstract
The population is ageing, with the greatest proportional increase in those >80 years of age. Many of these people will be frail and at risk of stroke. Research has shown that the very old have much to benefit from hyperacute stroke intervention, but at the same time they suffer increased mortality. Their outcome following stroke and intervention is more often predicted by the presence of frailty rather than age alone. Intervention both in primary prevention and hyperacute stroke management needs to allow for preexisting morbidity and frailty in deciding what is and what is not appropriate, rather than an arbitrary decision on age. Frail older people are more likely to develop delirium and dysphagia combined with poor mouthcare and die, yet all of these issues are managed badly. An increased awareness of these complications of stroke in the frail older person is necessary.
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Lindroos E, Jyväkorpi S, Soini H, Muurinen S, Saarela R, Pitkala K, Suominen M. Swallowing difficulty and nutrient intakes among residents in assisted living facilities in Helsinki. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Nozue M, Ishikawa M, Takemi Y, Kusama K, Fukuda Y, Yokoyama T, Nakaya T, Nishi N, Yoshiba K, Murayama N. Prevalence of Inadequate Nutrient Intake in Japanese Community-Dwelling Older Adults Who Live Alone. J Nutr Sci Vitaminol (Tokyo) 2017; 62:116-22. [PMID: 27264096 DOI: 10.3177/jnsv.62.116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Dietary assessment of community-dwelling Japanese older adults who live alone using Dietary Reference Intakes (DRIs) is limited. The present study aimed to estimate the prevalence of inadequate nutrient intake among Japanese community-dwelling older adults by sex and young-old and old-old population groups to identify the most vulnerable groups that need support. A cross-sectional survey was conducted from October 2012 to October 2013 with community-dwelling adults aged 65 y or older who lived alone. Participants were drawn from six cities in four Japanese prefectures. We used two days of dietary survey data to estimate participants' usual intake. The proportion of inadequate intake was assessed using the Estimated Average Requirement (EAR) cut-point method, Tolerable Upper Intake Level, and the tentative dietary goal for preventing life-style related diseases (DG) based on DRIs for Japanese, 2015. Data for 494 participants (162 male, 332 female) over 988 d were examined to assess nutrient intake. We calculated the proportion of inadequate intake between males and females and between young-old and old-old population groups (65-74 y and ≥75 y) using chi-square or Fisher's exact tests. For six nutrients, the estimated proportion of participants with a usual intake below EAR was higher in males than females. In addition, a higher estimated proportion of female participants was within the DG range for the percentage of energy from protein, fat, and carbohydrates, and had a usual intake of two nutrients above DG than males. Our findings showed that among Japanese older adults, males were more vulnerable in terms of inadequate nutrient intake compared with females.
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Affiliation(s)
- Miho Nozue
- National Institute of Health and Nutrition, National institutes of Biomedical Innovation, Health and Nutrition
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Iinuma T, Hirata T, Arai Y, Takayama M, Abe Y, Fukumoto M, Fukui Y, Gionhaku N. Perceived swallowing problems and mortality risk in very elderly people ≥85 years old: Results of the Tokyo Oldest Old Survey on Total Health study. Gerodontology 2017; 34:313-319. [PMID: 28349594 DOI: 10.1111/ger.12265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to clarify whether perceived swallowing problems affect the life expectancy of very elderly individuals. BACKGROUND In an ageing society, oral function affects health status. In particular, a decline in swallowing function may increase the risk of various diseases, morbidity and malnutrition. MATERIALS AND METHODS We evaluated 526 elderly individuals aged ≥85 years. All participants completed a questionnaire and underwent oral, physical and mental health examinations. The comprehensive oral health assessment comprised a face-to-face interview that included a questionnaire on swallowing function. We estimated hazard ratios and 95% confidence intervals using the Cox proportional hazards model, adjusting for potential confounders between perceived swallowing problems and all-cause mortality over a 3-year period. RESULTS Over a 3-year follow-up period, 88 of 526 participants died and 68 participants complained of perceived swallowing problems. Perceived swallowing problems had statistically significant associations with physical status and function and nutrition. In the univariate analysis, perceived swallowing problems had statistically significant associations with an approximately 1.9-fold higher risk of all-cause mortality during the 3-year period (HR: 1.89, 95% CI: 1.14-3.14). In the multivariate analysis, the statistically significant association between perceived swallowing problems and all-cause mortality remained after adjusting for various confounding factors (HR: 1.73, 95% CI: 1.03-2.92). CONCLUSION Perceived swallowing disorders should be verified by a clinical examination, as they are associated with other health outcomes and increased all-cause mortality.
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Affiliation(s)
- Toshimitsu Iinuma
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Takumi Hirata
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Michiyo Takayama
- Center for Preventive Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Motoko Fukumoto
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Yusuke Fukui
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Nobuhito Gionhaku
- Department of Complete Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
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Baugreet S, Hamill RM, Kerry JP, McCarthy SN. Mitigating Nutrition and Health Deficiencies in Older Adults: A Role for Food Innovation? J Food Sci 2017; 82:848-855. [PMID: 28267864 DOI: 10.1111/1750-3841.13674] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 01/23/2017] [Accepted: 01/31/2017] [Indexed: 12/20/2022]
Abstract
The aim of this review is to describe the factors contributing to diminished food intake, resulting in nutritional deficiencies and associated health conditions in older adults and proposes food innovation strategies to mitigate these. Research has provided convincing evidence of a link between healthy eating patterns and healthy aging. There is a need to target new food product development (NPD) with functional health benefits specifically designed to address the particular food-related needs of older consumers. When developing foods for older adults, consideration should be given to the increased requirements for specific macro- and micronutrients, especially protein, calcium, vitamin D, and vitamin B. Changes in chemosensory acuity, chewing difficulties, and reduced or poor swallowing ability should also be considered. To compensate for the diminished appetite and reduced intake, foods should be energy dense, nutritionally adequate, and, most importantly, palatable, when targeting this cohort. This paper describes the potential of new food product development to facilitate dietary modification and address health deficiencies in older adults.
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Affiliation(s)
- Sephora Baugreet
- Food Quality and Sensory Science Dept., Teagasc Food Research Centre, Ashtown, Dublin, 15, Ireland.,Dept. of Food and Nutritional Sciences, Univ. College Cork, Cork, Ireland
| | - Ruth M Hamill
- Food Quality and Sensory Science Dept., Teagasc Food Research Centre, Ashtown, Dublin, 15, Ireland
| | - Joseph P Kerry
- Dept. of Food and Nutritional Sciences, Univ. College Cork, Cork, Ireland
| | - Sinéad N McCarthy
- Dept. of Agrifood Business and Spatial Analysis, Teagasc Food Research Centre, Ashtown, Dublin, 15, Ireland
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Mazzola P, Ward L, Zazzetta S, Broggini V, Anzuini A, Valcarcel B, Brathwaite JS, Pasinetti GM, Bellelli G, Annoni G. Association Between Preoperative Malnutrition and Postoperative Delirium After Hip Fracture Surgery in Older Adults. J Am Geriatr Soc 2017; 65:1222-1228. [PMID: 28263371 DOI: 10.1111/jgs.14764] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 11/01/2016] [Accepted: 11/07/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether poor nutritional status can predict postoperative delirium in elderly adults undergoing hip fracture surgery. DESIGN Prospective observational cohort study. SETTING Italian orthogeriatric unit. PARTICIPANTS Individuals aged 70 and older (mean age 84.0 ± 6.6, 74.5% female) consecutively admitted for surgical repair of a proximal femur fracture between September 2012 and April 2016 (N = 415). MEASUREMENTS Participants underwent a comprehensive geriatric assessment including nutritional status, which was evaluated using the Mini Nutritional Assessment Short Form (MNA-SF). The MNA-SF-based three-class stratification was tested using multivariable logistic regression to assess its role in predicting postoperative delirium (outcome). RESULTS Seventy-eight malnourished individuals (MNA-SF score 0-7), 185 at risk of malnutrition (MNA-SF score 8-11), and 152 who were well nourished (MNA-SF score 12-14) were compared. On average, individuals with poor nutritional status were more disabled and more cognitively impaired than those who were well nourished and those at risk of malnutrition. Moreover, those who were malnourished were more likely to have postoperative delirium. Multivariate regression analysis adjusted for age, sex, comorbidity, functional impairment, preoperative cognitive status, and American Society of Anesthesiologists score showed that those who were at risk of malnutrition (odds ratio (OR) = 2.42, 95% confidence interval (CI) = 1.29-4.53) and those who were overtly malnourished (OR = 2.98, 95% CI = 1.43-6.19) were more likely to develop postoperative delirium. CONCLUSION This is the first study in a Western population showing that risk of malnutrition and overt malnutrition, as assessed using the MNA-SF, are independent predictors of postoperative delirium. Accordingly, nutritional status should be assessed in individuals with hip fracture before surgery to determine risk of developing delirium.
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Affiliation(s)
- Paolo Mazzola
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,NeuroMI-Milan Center for Neuroscience, Clinical Neurosciences Research Area, Monza, Italy
| | - Libby Ward
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sara Zazzetta
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Valentina Broggini
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Alessandra Anzuini
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Breanna Valcarcel
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Justin S Brathwaite
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Giulio M Pasinetti
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.,Geriatric Research, Education, and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,NeuroMI-Milan Center for Neuroscience, Clinical Neurosciences Research Area, Monza, Italy.,Acute Geriatrics Unit, San Gerardo Hospital ASST Monza, Monza, Italy
| | - Giorgio Annoni
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,NeuroMI-Milan Center for Neuroscience, Clinical Neurosciences Research Area, Monza, Italy.,Acute Geriatrics Unit, San Gerardo Hospital ASST Monza, Monza, Italy
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