Abstract
Purpose: Anatomical and physiological changes due to aging decrease the efficiency of swallowing and increase the risk of aspiration pneumonia. One of the underlying causes of recurrent pneumonia is swallowing dysfunction, with aspiration. This study aimed to compare the swallowing function in elderly patients with and without pneumonia and to investigate its association with malnutrition. Methods: A total of 44 elderly individuals with 22 aspiration pneumonia history (age=73.00±7.93 years) (study group) and 22 without aspiration pneumonia history (age=70.00±6.39 years) (control group) were included in the study. The swallowing function was evaluated using the Swallowing Ability Function Evaluation (SAFE) and water-swallowing test. Nutritional assessment was performed using the Turkish version of the Mini-Nutritional Assessment. Results: Decreased swallowing ability was observed in 59.1% of the study group and 9.1% of the control group (p<0.001). While the study group had severe disorder the 22.7% of the oral phase and 31.8% of the pharyngeal phase, the control group had no severe disorder. However, there was a 9.1% moderate disorder in the oral and pharyngeal phases in the control group (p<0.001). There was a relationship between the nutritional assessment results of the study group and the oral (r=0.498, p=0.018) and pharyngeal phases of SAFE (r=0.622, p=0.002). Conclusion: Our study showed that the swallowing function is affected in the elderly with a history of pneumonia. It was also observed in the elderly without a history of pneumonia. For this reason, a detailed swallowing evaluation must be performed both elderly patients with and without pneumonia, and a protective swallowing rehabilitation program should be developed through an interdisciplinary approach.
Keywords
References
- Aslam M, Vaezi MF. Dysphagia in the elderly. Gastroenterol hepatol. 2013;9(12):784.
- Pikus L, Levine MS, Yang YX, Rubesin SE, Katzka DA, Laufer I. Videofloroscopic studies of swallowing dysfunction and the relative risk of pneumonia. AJR Am J Roentgenol. 2003;180(6):1613-6.
- Langmore SE, Skarupski KA, Park PS, Fries BE. Predictors of aspiration pneumonia in nursing home residents. Dsyphagia. 2002;17(4):298-307.
- Yoshikawa M, Yoshida M, Nagasaki T. Aspects of swallowing in health dentate elderly persons older than 80 years. J Gerontol A Biol Sci Med Sci. 2005;60(4):506-9.
- Jaffe KM, MacDonald CM, Ingman E. Symptoms of upper gastrointestinal dysfunction in Duchenne muscular dystrophy case-control study. Arch Phys Med Rehabil. 1990;71(10):742-4.
- Winterholler C. Diagnosis and treatment of dysphagia in patients with neuromuscular disease. Pneumologie. 2008;62(Suppl 1):35-8.
- Yamanda S, Ebihara S, Ebihara T, Yamasaki M, Asamura T, Asada M, et al. İmpaired urge to cough in elderly patients with aspiration pneumonia. Cough. 2008;4:11.
- Dantas RO, Alves LM, Santos CM, Cassiani RA. Possible interaction of gender and age on human swallowing behavior. Arg Gastroenterol. 2011; 48(3): 195-8.
- González-Fernández M, Humbert I, Winegrad H, Cappola A, Linda P. Dysphagia in old-old women: prevalence as determined by self-report and the 3 oz. Water swallowing test. J Am Geriatr Soc. 2014;62(4):716-720.
- Kubota T, Mishima H, Hanada M. Sogo Rehabilitation.1982;10:271-276.
- Akai M. Dysphagia rehabilitation manual. Japan: 2015.
- Kipping P, Ross-Swain D, Yee PA. SAFE, Swallowing ability and functional evaluation. Pro-ed; 2003.
- Sarikaya D, Halil M, Kuyumcu ME, Kilic MK, Yesil Y, Kara O, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60.
- Güngen C, Ertan T, Eker E, Yaşar R. Reliability and Validity of The Standardized Mini Mental State Examination in The Diagnosis of Mild Dementia in Turkish Population. Turk J Phys. 2002;13(4):273-281.
- Nogueira D, Reis E. Swallowing disorders in nursing home residents: how can the problem be explained? Clin Interv Aging. 2013;8:221-7.
- Hiramatsu T, Kataoka H, Osaki M, Hagino H. Effect of aging on oral and swallowing function after meal consumption. Clin Interv Aging. 2015;10:229-235.
- Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreolae V, et al. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respır. J 2013;41(4):923-8.
- Nakazawa H, Sekizawa K, Ujiie Y, Sasaki H, Takishima T. Risk of aspiration pneumonia in the elderly. Chest. 1993;103(5):1636-7.
- Cabre M, Serra-Prat M, Palomera E, Almırall J, Pallares R, Clavé P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. 2010;39(1):39-45.
Abstract
Amaç: Yaşlanma ile birlikte oral motor yapılardaki zayıflık, reflekslerde yavaşlama gibi anatomik ve fizyolojik değişimler yutma etkinliğinde azalmaya yol açarak aspirasyon pnömonisi riski oluşturmaktadır. Tekrarlayan pnömoninin altında yatan nedenlerden biri, aspirasyon ile birlikte yutma disfonksiyonudur. Bu çalışmada pnömoni öyküsü olan ve olmayan yaşlılarda yutma fonksiyonlarının karşılaştırılması ve malnutrisyon ile ilişkisini incelenmesi amaçlandı. Yöntem: Çalışmamıza 22 aspirasyon pnömoni öyküsü bulunan (yaş=73,00±7,93 yıl) (çalışma grubu) ve 22 aspirasyon pnömoni öyküsü bulunmayan (yaş=70,00±6,39 yıl) (kontrol grubu) toplam 44 yaşlı birey dahil edildi. Yutma fonksiyonu değerlendirmesinde Yutma Yeteneği ve Fonksiyonu Değerlendirmesi (SAFE) ve su yutma testi kullanıldı. Beslenme değerlendirmesi, Mini-Nutrisyonel Değerlendirme'nin Türkçe versiyonu ile yapıldı. Sonuçlar: Çalışma grubunun % 59,1’inde yutma becerisinde azalma bulunurken, kontrol grubunda bu oran % 9,1’di (p<0,001). Çalışma grubunda oral fazın % 22.7'sinde ve faringeal fazın % 31,8'inde şiddetli bozukluk gözlenirken, kontrol grubunda şiddetli bozukluk yoktu ancak kontrol grubunda oral ve farengeal fazlarda % 9,1 oranında orta düzeyde bozukluk gözlendi (p<0,001). Çalışma grubunun beslenme değerlendirme sonuçları ile SAFE'nin oral (r=0,498, p=0,018) ve farengeal (r=0,622, p=0,002) evreleri arasında ilişki olduğu görüldü. Tartışma: Çalışmamız pnömoni öyküsü olan yaşlılarda yutma fonksiyonunun etkilendiğini göstermiştir. Bununla birlikte pnömoni öyküsü olmayan yaşlılarda da etkilenim gözlenmiştir. Bu sebepten dolayı pnömoni öyküsü olan ve olmayan yaşlılara detaylı bir yutma değerlendirmesi yapılmalı ve interdisipliner bir yaklaşımla koruyucu yutma rehabilitasyon programı oluşturulmalıdır.
References
- Aslam M, Vaezi MF. Dysphagia in the elderly. Gastroenterol hepatol. 2013;9(12):784.
- Pikus L, Levine MS, Yang YX, Rubesin SE, Katzka DA, Laufer I. Videofloroscopic studies of swallowing dysfunction and the relative risk of pneumonia. AJR Am J Roentgenol. 2003;180(6):1613-6.
- Langmore SE, Skarupski KA, Park PS, Fries BE. Predictors of aspiration pneumonia in nursing home residents. Dsyphagia. 2002;17(4):298-307.
- Yoshikawa M, Yoshida M, Nagasaki T. Aspects of swallowing in health dentate elderly persons older than 80 years. J Gerontol A Biol Sci Med Sci. 2005;60(4):506-9.
- Jaffe KM, MacDonald CM, Ingman E. Symptoms of upper gastrointestinal dysfunction in Duchenne muscular dystrophy case-control study. Arch Phys Med Rehabil. 1990;71(10):742-4.
- Winterholler C. Diagnosis and treatment of dysphagia in patients with neuromuscular disease. Pneumologie. 2008;62(Suppl 1):35-8.
- Yamanda S, Ebihara S, Ebihara T, Yamasaki M, Asamura T, Asada M, et al. İmpaired urge to cough in elderly patients with aspiration pneumonia. Cough. 2008;4:11.
- Dantas RO, Alves LM, Santos CM, Cassiani RA. Possible interaction of gender and age on human swallowing behavior. Arg Gastroenterol. 2011; 48(3): 195-8.
- González-Fernández M, Humbert I, Winegrad H, Cappola A, Linda P. Dysphagia in old-old women: prevalence as determined by self-report and the 3 oz. Water swallowing test. J Am Geriatr Soc. 2014;62(4):716-720.
- Kubota T, Mishima H, Hanada M. Sogo Rehabilitation.1982;10:271-276.
- Akai M. Dysphagia rehabilitation manual. Japan: 2015.
- Kipping P, Ross-Swain D, Yee PA. SAFE, Swallowing ability and functional evaluation. Pro-ed; 2003.
- Sarikaya D, Halil M, Kuyumcu ME, Kilic MK, Yesil Y, Kara O, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60.
- Güngen C, Ertan T, Eker E, Yaşar R. Reliability and Validity of The Standardized Mini Mental State Examination in The Diagnosis of Mild Dementia in Turkish Population. Turk J Phys. 2002;13(4):273-281.
- Nogueira D, Reis E. Swallowing disorders in nursing home residents: how can the problem be explained? Clin Interv Aging. 2013;8:221-7.
- Hiramatsu T, Kataoka H, Osaki M, Hagino H. Effect of aging on oral and swallowing function after meal consumption. Clin Interv Aging. 2015;10:229-235.
- Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreolae V, et al. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Respır. J 2013;41(4):923-8.
- Nakazawa H, Sekizawa K, Ujiie Y, Sasaki H, Takishima T. Risk of aspiration pneumonia in the elderly. Chest. 1993;103(5):1636-7.
- Cabre M, Serra-Prat M, Palomera E, Almırall J, Pallares R, Clavé P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. 2010;39(1):39-45.
Details
| Primary Language | English |
|---|---|
| Subjects | Rehabilitation |
| Journal Section | Araştırma Makaleleri |
| Authors | |
| Publication Date | December 17, 2020 |
| Published in Issue | Year 2020 Volume: 31 Issue: 3 |