Time Spent Away from Bed to Maintain Swallowing Function in Older Adults

Ishii, Miki; Nakagawa, Kazuharu; Yoshimi, Kanako; Okumura, Takuma; Hasegawa, Shohei; Yamaguchi, Kohei; Nakane, Ayako; Tamai, Tomoe; Nagasawa, Yuki; Yoshizawa, Atsushi; Tohara, Haruka

doi:10.1159/000522499

Cited by 9 publications

(7 citation statements)

References 37 publications

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“…Considering this, physical activity intervention may be an effective approach for improving intramuscular adipose tissue in the quadriceps in older inpatients with aspiration pneumonia. Ishii et al [ 50 ] targeted older patients with low ADL and reported that the swallowing ability in older patients who spent 4 or more hours away from the bed in a day was higher than that of older patients who spent less than 4 hours away from the bed. The results of this study indicate that there is a relationship between physical activity and swallowing ability, and thus, support our hypothesis (intervention with physical activity for decreasing intramuscular adipose tissue of the quadriceps is needed to improve swallowing ability in older patients with aspiration pneumonia).…”

Section: Discussionmentioning

confidence: 99%

The degree of recovery in swallowing ability in older inpatients with aspiration pneumonia is related to intramuscular adipose tissue of the quadriceps than to muscle mass

Akazawa

Kishi²,

Hino³

et al. 2022

PLoS ONE

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Background & aim A recent study reported that the increase in intramuscular adipose tissue of the quadriceps in older inpatients is related to a decreasing degree of recovery in swallowing ability compared to the loss of muscle mass. However, whether the association remains true in case of aspiration pneumonia is unclear. Therefore, this study aimed to examine the relationship between the degree of recovery in swallowing ability and intramuscular adipose tissue in the quadriceps of older inpatients with aspiration pneumonia. Methods This prospective study included 39 older patients with aspiration pneumonia. Swallowing ability was assessed using the Food Intake Level Scale (FILS). The indicators for the degree of recovery in swallowing ability were FILS at discharge and change in FILS. A greater change in FILS indicates a greater improvement in swallowing ability. Intramuscular adipose tissue and muscle mass of the quadriceps were evaluated at admission using echo intensity and muscle thickness on ultrasound images, respectively. Multiple regression analysis was used to determine whether the echo intensity of the quadriceps was independently and significantly related to FILS at discharge and the change in FILS. Independent variables were age, sex, days from disease onset, echo intensity and muscle thickness of the quadriceps, subcutaneous fat thickness of the thigh, FILS at admission, and number of units of rehabilitation therapy. Results Echo intensity of the quadriceps (β = −0.363, p = 0.012) and FILS at admission (β = 0.556, p < 0.001) were independently and significantly associated with FILS at discharge (R2 = 0.760, f2 = 3.167, statistical power = 1.000). Similar variables (echo intensity of the quadriceps [β = −0.498, p = 0.012] and FILS at admission [β = −0.635, p < 0.001]) were independently and significantly related to change in FILS (R2 = 0.547, f2 = 1.208, statistical power = 0.998). Quadriceps muscle thickness was not independently and significantly related to FILS at discharge and change in FILS. Conclusion Our results indicate that intramuscular adipose tissue of the quadriceps in older inpatients with aspiration pneumonia is more strongly related to the degree of recovery in swallowing ability (that is, swallowing ability at discharge and change in swallowing ability) than muscle mass, and patients who have high intramuscular adipose tissue of the quadriceps at admission have a lower degree of recovery in swallowing ability.

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Section: Discussionmentioning

confidence: 99%

The degree of recovery in swallowing ability in older inpatients with aspiration pneumonia is related to intramuscular adipose tissue of the quadriceps than to muscle mass

Akazawa

Kishi²,

Hino³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

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“…For patients who do not prefer community or common dining, chairs and tables in the rooms can be used. Over-the-bed tables promote time in bed and increase risk of aspiration, so should not be a part of geriatric hospitals ( Manganelli et al., 2014 ; Ishii et al, 2022 ).…”

Section: Geriatric Hospitals: Changing Typical Processes Of Care and ...mentioning

confidence: 99%

Changing Hospital Care For Older Adults: The Case for Geriatric Hospitals in the United States

Flaherty

Rodin

Morley

2022

Gerontology and Geriatric Medicine

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Hospital care of frail older adults is far from optimal. Although some geriatric models of care have been shown to improve outcomes, the effect size is small and models are difficult to fully implement, sustain and replicate. The two root causes for these shortcomings are competing interests (high revenue generating diseases, procedures and surgeries) and current hospital cultures (for example a culture of safety that emphasizes bed alarms and immobility rather than frequent ambulation). Geriatric hospitals would be hospitals completely dedicated to the care of frail older patients, a group which is most vulnerable to the negative consequences of a hospitalization. They would differ from a typical adult hospital because they could implement evidence based principles of successful geriatric models of care on a hospital wide basis, which would make them sustainable and allow for scaling up of proven outcomes. Innovative structural designs, unachievable in a typical adult hospital, would enhance mobility while maintaining safety. Financial viability and stability would be a challenge but should be feasible, likely through affiliation with larger health care systems with other hospitals because of cost savings associated with geriatric models of care (decreased length of stay, increased likelihood of discharge home, without increasing costs).

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“…Crosssectional studies have found that healthy adults who are more physically active have higher tongue strength and longer endurance, with the association more obvious in older adults (VanRavenhorst-Bell et al, 2017). Focusing on older adults, those who were more active in daily life have shown better performance in oromotor (Izuno et al, 2016;Morishita et al, 2021) and swallowing measurements (Ishii et al, 2022(Ishii et al, , 2023Morishita et al, 2021). The mode of physical activity may also make a difference, with adults who are weight lifters showing higher tongue strength and runners showing longer tongue endurance (VanRavenhorst-Bell et al, 2018); this suggests that there may be a difference between the transfer of aerobic and anaerobic WBE effects to non-targeted muscles.…”

Section: Introductionmentioning

confidence: 99%

The use and effects of whole‐body exercises on swallowing function: A scoping review

Yao

2023

Intl J Lang & Comm Disor

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Background: Swallowing function can become impaired due to primary medical conditions or age-related presbyphagia, resulting in swallowing disorders, known as dysphagia. Specific manoeuvres that target different musculature have been innovated and researched, but whole-body exercises (WBE) that target multiple large groups of body systems and muscles have been rarely considered in dysphagia management, despite the causes of dysphagia being often systemic. Aims: To identify intervention studies that have used or incorporated WBE to target swallowing function in humans, and report on their findings. Methods & Procedures: A scoping review was conducted given the paucity and novelty of this topic in research and practice. Key search terms were used to search five major databases on for all human studies published before 28 November 2022. Studies that were not interventional or used animal models were excluded. All swallowing and oromotor-related outcomes were extracted from the studies. Two researchers independently reviewed all search results following the PRISMA-ScR guideline before meeting to resolve any disagreements. Main Contribution: Final analysis was conducted on 11 papers that described 10 studies, with 10 papers (9 studies) reporting positive findings for swallowing or oromotor function-related outcomes. Studies ranged from randomised controlled trials to case studies in design. The study design and populations were heterogeneous, with outcome measures for swallowing and oromotor function ranging from subjective questionnaires to instrumental assessments.Conclusions & Implications: Dysphagia rehabilitation that incorporates WBE as part of a comprehensive programme appears to be more beneficial than either WBE or swallowing-related interventions alone. This review is an initial attempt to systematically examine the evidence on this topic. There is a need for future research to study how WBE can be used, either alone or combined with traditional swallowing exercises, to influence swallowing function in different healthy and clinical populations.

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Time Spent Away from Bed to Maintain Swallowing Function in Older Adults

Cited by 9 publications

References 37 publications

The degree of recovery in swallowing ability in older inpatients with aspiration pneumonia is related to intramuscular adipose tissue of the quadriceps than to muscle mass

The degree of recovery in swallowing ability in older inpatients with aspiration pneumonia is related to intramuscular adipose tissue of the quadriceps than to muscle mass

Changing Hospital Care For Older Adults: The Case for Geriatric Hospitals in the United States

The use and effects of whole‐body exercises on swallowing function: A scoping review

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