Nutritional Assessment in Adult Patients with Dysphagia: A Scoping Review

Ueshima, Junko; Momosaki, Ryo; Shimizu, Akio; Motokawa, Köiti; Sonoi, Mika; Shirai, Yuji; Uno, Chiharu; Kokura, Yoji; Shimizu, Midori; Nishiyama, Akiko; Moriyama, Daisuke; Yamamoto, Kaori; Sakai, Kotomi

doi:10.3390/nu13030778

Cited by 29 publications

(21 citation statements)

References 121 publications

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“…A recent review suggested using the Global Leadership Initiative on Malnutrition (GLIM) criteria to assess the nutritional status of dysphagic adult patients. This covers BMI, nutritional screening tools, anthropometric measurements, body composition and dietary assessment [ 65 ]. Standardised nutritional assessment, nutrition recommendations for texture and nutrients should be included as part of dysphagia diagnosis and treatment plan [ 63 , 64 , 66 ].…”

Section: Discussionmentioning

confidence: 99%

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Miles

Braakhuis

2021

Healthcare

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While the association between dysphagia and malnutrition is well established, there is a lack of clarity regarding the nutritional status and mealtime satisfaction of those consuming texture-modified diets (TMDs). This systematic review summarises and critically appraises the nutritional status and mealtime satisfaction of adults consuming TMDs. A systematic database search following PICO criteria was conducted using Cochrane Central (via Ovid), MEDLINE, CINAHL, EMBASE and Scopus. Nutritional status, mealtime satisfaction and costs were identified as primary outcomes. Eligible studies were grouped according to outcome measurement. In total, 26 studies met the inclusion criteria. Twenty studies evaluated the nutritional status by weight change or using malnutrition screening tools and found the consumption of TMDs correlated with weight loss or malnutrition. Nine studies evaluated mealtime satisfaction, with two reporting poor satisfaction for people on thickened fluids (TFs). Nutrition intervention through adjusting texture and consistency and nutrition enrichment showed positive effects on weight and mealtime satisfaction. The majority of the studies were rated as ‘neutral’ quality due to the limited number of experiments. TMD consumers had compromised nutritional status and poor mealtime satisfaction. More research input is required to identify promising strategies for improving the nutritional status and mealtime satisfaction of this population. Food services need to consider texture, consistency and fortification in designing menus for people on TMDs to avoid weight loss and malnutrition, and to enhance mealtime enjoyment.

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Section: Discussionmentioning

confidence: 99%

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Miles

Braakhuis

2021

Healthcare

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“…Therefore, nutritional assessment is critical in older patients with dysphagia to determine optimal nutritional interventions and improve patient outcomes. The most commonly used nutritional assessment item is BMI [21]. In this study, we focused on AWT as a potential indicator of nutritional assessment as it has been reported to have a positive correlation with BMI [11].…”

Section: Discussionmentioning

confidence: 99%

“…Although there were some missing data and both the complete case analysis and the multiple imputation analysis were performed, the results were robust. Since TLC and BMI are major nutritional assessment items [7,8,21,25,26], AWT can be defined as a variable indicative of nutritional status. Although the association between AWT and nutritional status has not been fully validated in previous studies, our study has demonstrated the validity of using AWT as a nutritional indicator.…”

Section: Discussionmentioning

confidence: 99%

“…There was a significant difference in each variable between the three groups. using the GLIM criteria is critical because malnutrition is strongly associated with the onset of sarcopenia, which leads to lowered quality of life due to impairment of activities of daily living and increased mortality [21,29,30]. The characteristics of the GLIM criteria include the evaluation of both BMI and muscle mass.…”

Section: Discussionmentioning

confidence: 99%

“…The characteristics of the GLIM criteria include the evaluation of both BMI and muscle mass. This is reasonable because BMI is the most common nutritional assessment item [21], and muscle mass is among the main parameters of sarcopenia [29]. Thus, AWT, which is associated with BMI and reflects the thickness of the rectus abdominis muscle, can be used as an anthropometric measurement for diagnosing malnutrition using the GLIM criteria in older patients with dysphagia.…”

Section: Discussionmentioning

confidence: 99%

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Nutritional and prognostic significance of abdominal wall thickness measured during percutaneous endoscopic gastrostomy in older individuals with dysphagia

Masaki

Kimura

2021

Clinical Nutrition ESPEN

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Background & aims: The significance of abdominal wall thickness (AWT) for nutritional assessment remains unclear. This study aimed to evaluate the nutritional and prognostic significance of AWT measured during percutaneous endoscopic gastrostomy (PEG) in older patients with dysphagia. Methods: This single-center retrospective cohort study enrolled older adults with dysphagia who underwent PEG for enteral nutrition using the introducer technique between February 2010 and January 2019. We examined the association between AWT measured during PEG and nutritional status items, including body mass index (BMI), serum albumin (Alb), total lymphocyte count (TLC), total cholesterol (TC), hemoglobin (Hb), and C-reactive protein (CRP). The shaft length of the PEG tube inserted, which is an approximation value of the AWT, was used for statistical analysis. Patients were divided into three groups: low-AWT group (shaft length 2.5 cm), medium-AWT group (shaft length 3.0e3.5 cm), and high-AWT group (shaft length !4.0 cm). We performed the KruskaleWallis test and multiple linear regression analysis with multiple imputation. We performed survival analysis using the KaplaneMeier method, log-rank test, and Cox regression analysis. Results: A total of 520 patients were identified: 115, 258, and 147 patients in the low-AWT, medium-AWT, and high-AWT groups, respectively. Higher AWT was significantly associated with higher BMI, Alb, TLC, TC, Hb, and lower CRP levels. Multiple linear regression analysis revealed that BMI and TLC were significant predictors of AWT (BMI: coefficient 1.16E-01, 95% confidence interval [CI], 9.77E-02e1.33E-01, P < 0.001; TLC: coefficient 1.18E-04, 95% CI, 2.72E-05e2.09E-04, P ¼ 0.011). The median survival time was the longest in the high-AWT group (low-AWT, 359 days; medium-AWT, 851 days; high-AWT, 1662 days; P < 0.001). The hazard ratio for the high-AWT group relative to the medium-AWT group was 0.59 (95% CI, 0.41e0.85, P ¼ 0.004), and that relative to the low-AWT group was 0.34 (95% CI, 0.24e0.51, P < 0.001). Conclusions: Higher AWT was associated with better nutritional status and survival. AWT may help assess nutritional status and predict survival in older dysphagic patients with PEG.

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Preoperative dysphagia risk in community‐dwelling adults aged ≥50 years: Prevalence and risk factors

et al. 2022

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Background: Preoperative dysphagia screening is rare. The purpose of this study was to assess the prevalence and potential risk factors of preoperative dysphagia risk in adults preparing for surgery. Methods:The Eating Assessment Tool (EAT-10), Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), and Sarcopenia Screening Tool (SARC-F) were self-administered in adults preparing for surgery to identify dysphagia, malnutrition, and sarcopenia risk, respectively. Other variables collected include clinical demographics, fall risk, and surgical history associated with increased dysphagia risk. Descriptive summary statistics, univariate analysis, and logistic regression were performed as appropriate.Results: The median age was 69 years and preoperative dysphagia risk was 9.6%. Among 357 patients completing both EAT-10 and PG-SGA SF or SARC-F, 7.3% had preoperative dysphagia and malnutrition risk and 7.2% had preoperative dysphagia and sarcopenia risk. Preoperative dysphagia risk was 2.7 times greater in those with prior surgical history associated with increased risk of dysphagia, 2.2 times higher in women, and almost twice as high in Black patients and patients with fall risk. Logistic regression revealed significant odds ratios (ORs) for prior surgical history associated with increased risk of dysphagia (OR, 2.95; 95% CI, 1.62-5.40) and male sex (OR, 0.52; 95% CI, 0.29-0.94), and a significant relationship between preoperative dysphagia and malnutrition risk (OR, 4.56; 95% CI, 2.02-10.28) when controlling for clinical variables. Conclusion:The high prevalence of dysphagia risk alone and in combination with malnutrition and sarcopenia risk in community-dwelling adults underscores the need for standardized preoperative screening and optimization prior to surgery.

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Nutritional Assessment in Adult Patients with Dysphagia: A Scoping Review

Cited by 29 publications

References 121 publications

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review

Nutritional and prognostic significance of abdominal wall thickness measured during percutaneous endoscopic gastrostomy in older individuals with dysphagia

Preoperative dysphagia risk in community‐dwelling adults aged ≥50 years: Prevalence and risk factors

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