Evaluation of a dysphagia screening system based on the Mann Assessment of Swallowing Ability for use in dependent older adults
Evaluation of a dysphagia screening system based on the Mann Assessment of Swallowing Ability for use in dependent older adults
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DOI：
10.1111/ggi.12755
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发表时间：
2017-04-01
影响因子：
3.3
通讯作者：
Sato, Toru
中科院分区：
文献类型：
--
作者：
Ohira, Mariko;Ishida, Ryo;Sato, Toru
吞咽困难在依赖他人的老年人中很常见。因此，需要一种评估进食和吞咽功能的方法，以一种简单而有力的方式来诊断和治疗吞咽困难。2002年，引入Mann吞咽能力评估（MASA）来识别急性期脑卒中患者的吞咽困难。由于MASA可以方便地进行筛选，如果可以确定适当的MASA临界值和最有用的评估项目，它也可能适用于受抚养的老年人。在本研究中，我们试图确定合适的MASA临界值，以及预测依赖老年人误吸和咽潴留的最有用的评估项目。方法对50例老年吞咽困难患者进行吞咽吞咽功能测定。所有患者还接受了基于视频内窥镜的吞咽评估，以检测误吸和咽潴留。比较各组被试的特征及各评估项目的效用。以患者的内镜影像为参考，进行受试者工作特征曲线分析，以确定预测依赖老年人误吸和咽潴留的合适临界值。结果预测误吸和咽潴留的最佳MASA临界值分别为122分和151分。在由MASA评估的24项临床项目中，共有17项被发现与依赖老年人的误吸有关。结论MASA是评估老年人进食和吞咽功能的有效筛查工具。Geriatr Gerontol Int 2017；17: 561 - 567。
AimDysphagia is common in dependent older adults. Thus, a method of evaluating eating and swallowing functions that can be used to diagnose and manage dysphagia in a simple and robust manner is required. In 2002, the Mann Assessment of Swallowing Ability (MASA) was introduced to identify dysphagia in acute-stage stroke patients. As the MASA enables easy screening, it might also be applicable to dependent older adults if appropriate MASA cut-off values and the most useful assessment items could be determined. In the present study, we attempted to determine suitable MASA cut-off values, and the most useful assessment items for predicting aspiration and pharyngeal retention in dependent older adults.MethodsUsing the MASA, we evaluated the eating and swallowing functions of 50 dependent older adults with dysphagia. All of the patients also underwent videoendoscopic-based swallowing evaluations to detect aspiration and pharyngeal retention. The participants' characteristics and the utility of each assessment item were compared between various groups. Using the patients' videoendoscopic findings as a reference, receiver operating characteristic curve analysis was carried out to determine appropriate cut-off values for predicting aspiration and pharyngeal retention in dependent older adults.ResultsThe optimal MASA cut-off values for predicting aspiration and pharyngeal retention were 122 points and 151 points, respectively. A total of 17 of the 24 clinical items assessed by the MASA were found to be associated with aspiration in dependent older adults.ConclusionsThe MASA is a useful screening tool for evaluating eating and swallowing functions in dependent older adults. Geriatr Gerontol Int 2017; 17: 561-567.