The investigation of asymptomatic swallowing disorder through surface electromyography in the geriatric population

The prevalence of presbyphagia in older adults: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVE

Presbyphagia is defined as structural, physiological and innervational alterations in the swallowing process as a result of aging and is considered to be involved in the etiology of dysphagia. This systematic review and meta-analysis aimed to estimate the prevalence of presbyphagia in older adults without disease-related dysphagia.

METHODS

In this study five databases were searched in October 2023 with no time limitation. Combined effect sizes of presbyphagia prevalence were calculated using random effect models. Meta-regression and subgroup analyses were conducted to identify sources of heterogeneity. Egger's test and a funnel plot were employed to examine publication bias.

RESULTS

A total of 19 studies were selected for analysis. Overall, the prevalence of presbyphagia in older adults was 30.8% (95% confidence interval [CI] 24.8-36.7%). Publication bias was adjusted for using the fill-and-trim method and the corrected pooled prevalence of presbyphagia was 17.3% (95% CI 11.0-23.6%). In addition, the meta-regression findings revealed that the assessment tool had significant effects upon heterogeneity.

CONCLUSION

Although the pooled prevalence of presbyphagia in older adults was 17.3%, the lack of large representative studies limited the interpretation of these findings. In the future, further large studies that diagnose presbyphagia using standardized assessment tools would facilitate new avenues to reduce the risk of dysphagia in older adults.

Analysis of the Hanging Actions and Operating Heights of Storage Furniture Suitable for the Elderly

The current functional scale design of storage furniture which the elderly use does not meet their needs, and unsuitable storage furniture may bring many physiological and psychological problems to their daily lives. The purpose of this study is to start with the hanging operation, to study the factors influencing the hanging operation heights of elderly people undergoing self-care in a standing posture and to determine the research methods to be used to study the appropriate hanging operation height of the elderly so as to provide data and theoretical support for the functional design scale of storage furniture suitable for the elderly. This study quantifies the situations of elderly people's hanging operation through an sEMG test performed on 18 elderly people at different hanging heights combined with a subjective evaluation before and after the operation and a curve fitting between the integrated sEMG indexes and the test heights. The test results show that the height of the elderly subjects had a significant effect on the hanging operation, and the main power muscles of the suspension operation were the anterior deltoid, upper trapezius and brachioradialis. Elderly people in different height groups had their own performance of the most comfortable hanging operation ranges. The suitable range for the hanging operation was 1536-1728 mm for seniors aged 60 or above whose heights were within the range of 1500-1799 mm, which could obtain a better action view and ensure the comfort of the operation. External hanging products, such as wardrobe hangers and hanging hooks, could also be determined according to this result.

A Comparative Assessment of the Diagnosis of Swallowing Impairment and Gastroesophageal Reflux in Canines and Humans

Swallowing impairment is a highly prevalent and clinically significant problem affecting people and dogs. There are myriad causes of swallowing impairment of which gastroesophageal reflux is the most common in both species. Similarities in anatomy and physiology between humans and canines results in analogous swallowing disorders including cricopharyngeus muscle achalasia, esophageal achalasia, hiatal herniation, and gastroesophageal reflux with secondary esophagitis and esophageal dysmotility. Accordingly, the diagnostic approach to human and canine patients with swallowing impairment is similar. Diagnostic procedures such as swallowing fluoroscopy, high-resolution manometry, pH/impedance monitoring, and endolumenal functional luminal imaging probe can be performed in both species; however, nasofacial conformation, increased esophageal length, and the difficulty of completing several of these procedures in awake dogs are inherent challenges that need to be considered. Human patients can convey their symptoms and respond to verbal cues, whereas veterinarians must rely on clinical histories narrated by pet owners followed by comprehensive physical examination and observation of the animal eating different food consistencies and drinking water. Dogs may also be unwilling to drink or eat in the hospital setting and may be resistant to physical restraint during diagnostic procedures. Despite the species differences and diagnostic challenges, dogs are a natural animal model for many oropharyngeal and esophageal disorders affecting people, which presents a tremendous opportunity for shared learnings. This manuscript reviews the comparative aspects of esophageal anatomy and physiology between humans and canines, summarizes the diagnostic assessment of swallowing impairment in both species, and discusses future considerations for collaborative medicine and translational research.