Dysphagia: A New Geriatric Syndrome

Payne, Michelle A.; Morley, John E.

doi:10.1016/j.jamda.2017.03.017

Cited by 37 publications

(24 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The recognition of this relationship highlights the fact that loss of muscle mass and strength is a universal aging phenomenon. 1 A position paper on "sarcopenia and dysphagia" was recently published by four professional organizations in Japan. 2 Sarcopenic dysphagia is defined as dysphagia due to sarcopenia in both generalized skeletal muscles and swallowing-related muscles, and is excluded if whole-body sarcopenia is absent.…”

Section: Introductionmentioning

confidence: 99%

“…Over the last few years, attention has been increasingly focused on the close relationship between dysphagia and sarcopenia. The recognition of this relationship highlights the fact that loss of muscle mass and strength is a universal aging phenomenon 1 . A position paper on “sarcopenia and dysphagia” was recently published by four professional organizations in Japan 2 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chair‐stand exercise improves post‐stroke dysphagia

Yoshimura¹,

Wakabayashi

Nagano³

et al. 2020

Geriatrics Gerontology Int

View full text Add to dashboard Cite

Aim: To elucidate the effects of whole-body exercise on clinical outcomes, including dysphagia status, between stroke patients with dysphagia who are undergoing convalescent rehabilitation. Methods: This retrospective cohort study included consecutive patients with post-stroke dysphagia in a rehabilitation hospital in Japan between 2016 and 2018. Dysphagia was defined as a Food Intake Level Scale (FILS) score <7. Participants were asked to perform a repeated chair-stand exercise as a whole-body exercise in addition to the convalescence rehabilitation program. Study outcomes included the FILS score and presence of dysphagia at discharge, the Functional Independence Measure-motor (FIM-motor) score and length of stay. Multivariate analyses were used to determine whether the frequency of daily chair-stand exercise was independently associated with study outcomes, after adjusting for potential confounders; P < 0.05 was considered statistically significant. Results: Of the 637 patients admitted, 148 stroke patients with dysphagia (mean age 72.7 years; 48.6% men) were included in the final analysis dataset. The median daily frequency of repeated chair-stand exercise was 36 (12-65). In multivariate analyses, the frequency of chair-stand exercise was independently associated with the FILS score at discharge (β = 0.231, P = 0.015), the presence of dysphagia at discharge (odds ratio: 0.982, P = 0.035), FIM-motor at discharge (β = 0.205, P = 0.008) and its gain (β = 0.237, P = 0.013), and length of hospital stay (β = −0.042, P < 0.001). Conclusions: Chair-stand exercise is associated with preferable clinical outcomes, including dysphagia status, activities of daily living and length of hospital stay, in stroke patients with dysphagia. Post-stroke dysphagia rehabilitation should include whole-body exercises in addition to conventional rehabilitation programs.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chair‐stand exercise improves post‐stroke dysphagia

Yoshimura¹,

Wakabayashi

Nagano³

et al. 2020

Geriatrics Gerontology Int

View full text Add to dashboard Cite

show abstract

“…A complaint of dysphagia in older adults should therefore be regarded as pathologic, especially given the wide spectrum of neuromuscular and structural disorders that increase in prevalence with age. 20 , 45 , 46 , 51 …”

Section: Discussionmentioning

confidence: 99%

Characterization of Geriatric Dysphagia Diagnoses in Age‐Based Cohorts

Applebaum¹,

Lee²,

Harun³

et al. 2020

OTO Open

View full text Add to dashboard Cite

Objective An aging population requires increased focus on geriatric otolaryngology. Patients aged ≥65 years are not a homogenous population, and important physiologic differences have been documented among the young-old (65-74 years), middle-old (75-84), and old-old (≥85). We aim to analyze differences in dysphagia diagnoses and swallowing-related quality-of-life among these age subgroups. Study Design Retrospective chart review. Setting Tertiary care laryngology clinic. Subjects and Methods We identified chief complaint, diagnosis, and self-reported swallowing handicap (Eating Assessment Tool [EAT-10] score) of all new patients aged ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017. Dysphagia diagnoses were classified by physiologic etiology and anatomic source. Diagnostic categories and EAT-10 score were evaluated as functions of patient age and sex. Results Of 839 new patients aged ≥65 years, 109 (13.0%) reported a chief complaint of dysphagia and were included in this study. The most common dysphagia etiologies were neurologic and esophageal. Most common diagnoses were diverticula (15.6%), reflux (13.8%), and radiation induced (8.3%). Diverticula, cricopharyngeal hypertonicity, and radiation-induced changes were associated with higher EAT-10 score ( P < .001). Significant differences by sex were found in anatomic source of dysphagia, as men and women were more likely to present with oropharyngeal and esophageal disease, respectively ( P = .023). Dysphagia etiology and EAT-10 score were similar across age subgroups. Conclusion Important differences among dysphagia diagnosis and EAT-10 score exist among patients aged ≥65 years. Knowledge of these differences may inform diagnostic workup, management, and further investigations in geriatric otolaryngology.

show abstract

“…In older adults, increased prevalence of physical frailty can increase the risk of cognitive decline and both may combine to have a negative impact on swallowing function. Recent research in dysphagia has also suggested that dysphagia may be part of a geriatric syndrome, associated with sarcopenia and medical and physical decline [46]. These are factors that need to be explored further when considering early identification in CDOA.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults

et al. 2018

View full text Add to dashboard Cite

Evidence suggests that community dwelling older adults (CDOA) are at risk for dysphagia (swallowing difficulties). Dysphagia is often unidentified until related morbidities like under nutrition or pneumonia occur. These cases of unidentified dysphagia, prior to any clinical intervention, may be termed ‘pre-clinical dysphagia’. Identifying pre-clinical dysphagia is challenged by the lack of validated tools appropriate for CDOA. This study addresses preliminary development of a novel patient reported outcome (PRO) screening tool for pre-clinical dysphagia. Initially, 34 questions were developed from literature review and expert opinion. Following pilot testing (n = 53), the questionnaire was revised and tested on 335 additional CDOA. Face validity, content validity, item analysis, reliability (internal consistency), and construct validity (exploratory factor analysis) measures were completed. Psychometric validation resulted in a 17-question PRO tool. Construct analysis identified a three-factor model that explained 67.345% of the variance. Emergent factors represented swallowing effort, physical function, and cognitive function. The results revealed strong construct validity and internal consistency (Cronbach’s α = 0.90). A novel, simple PRO incorporating multiple function domains associated with aging demonstrated strong preliminary psychometric properties. This tool is more comprehensive and aging-focused than existing dysphagia screening tools. Inclusion of multiple domains may be key in early identification of pre-clinical dysphagia.

show abstract

Dysphagia: A New Geriatric Syndrome

Cited by 37 publications

References 35 publications

Chair‐stand exercise improves post‐stroke dysphagia

Chair‐stand exercise improves post‐stroke dysphagia

Characterization of Geriatric Dysphagia Diagnoses in Age‐Based Cohorts

Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults

Contact Info

Product

Resources

About