Sarcopenia and dysphagia: Position paper by four professional organizations
Sarcopenia and dysphagia: Position paper by four professional organizations
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DOI：
10.1111/ggi.13591
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发表时间：
2019-02-01
影响因子：
3.3
通讯作者：
Yoshimura, Yoshihiro
中科院分区：
文献类型：
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作者：
Fujishima, Ichiro;Fujiu-Kurachi, Masako;Yoshimura, Yoshihiro
本报告由日本吞咽困难康复协会、日本康复营养协会、日本肌减少症和虚弱协会以及日本吞咽困难协会撰写，旨在巩固目前关于肌减少症和吞咽困难主题的可用证据。在组织学上，吞咽肌与躯体肌具有不同的胚胎起源，并接受来自呼吸中枢的持续输入刺激。虽然吞咽肌是横纹肌，但其特征与骨骼肌不同。吞咽肌不可避免地受到营养不良和废用的影响;关于营养不良对吞咽肌的影响，已有越来越多的证据。肌萎缩性吞咽困难是指全身肌肉减少和吞咽相关肌肉减少引起的吞咽困难。当肌肉减少症不存在于整个身体时，不应使用术语“肌肉减少性吞咽困难”。此外，应排除神经肌肉疾病引起的肌肉减少症;然而，衰老和不活动、营养不良和疾病（消耗性疾病和恶病质）后的继发性肌肉减少症包括在肌肉减少性吞咽困难中。由于肌肉减少症引起的吞咽困难的治疗需要吞咽困难康复，例如吞咽肌肉的阻力训练和营养干预。然而，如何诊断由吞咽肌肉的肌肉减少症引起的吞咽困难的基本问题仍然没有解决。此外，吞咽困难是否可以引起原发性肌肉减少症应予以澄清。此外，吞咽困难与继发性肌肉减少症的关系，以及诊断肌肉减少症引起的吞咽困难的诊断标准和方法等问题需要更多的讨论。Geriatr Gerontol Int 2019; 19：91-97.
This report was written by the Japanese Society of Dysphagia Rehabilitation, the Japanese Association of Rehabilitation Nutrition, the Japanese Association on Sarcopenia and Frailty, and the Society of Swallowing and Dysphagia of Japan to consolidate the currently available evidence on the topics of sarcopenia and dysphagia. Histologically, the swallowing muscles are of different embryological origin from somatic muscles, and receive constant input stimulation from the respiratory center. Although the swallowing muscles are striated, their characteristics are different from those of skeletal muscles. The swallowing muscles are inevitably affected by malnutrition and disuse; accumulating evidence is available regarding the influence of malnutrition on the swallowing muscles. Sarcopenic dysphagia is defined as dysphagia caused by sarcopenia of the whole body and swallowing-related muscles. When sarcopenia does not exist in the entire body, the term "sarcopenic dysphagia" should not be used. Additionally, sarcopenia due to neuromuscular diseases should be excluded; however, aging and secondary sarcopenia after inactivity, malnutrition and disease (wasting disorder and cachexia) are included in sarcopenic dysphagia. The treatment of dysphagia due to sarcopenia requires both dysphagia rehabilitation, such as resistance training of the swallowing muscles and nutritional intervention. However, the fundamental issue of how dysphagia caused by sarcopenia of the swallowing muscles should be diagnosed remains unresolved. Furthermore, whether dysphagia can be caused by primary sarcopenia should be clarified. Additionally, more discussion is required on issues such as the relationship between dysphagia and secondary sarcopenia, as well as the diagnostic criteria and means for diagnosing dysphagia caused by sarcopenia. Geriatr Gerontol Int 2019; 19: 91-97.