Effects of age and viscosity on food transport and breathing-swallowing coordination during eating of two-phase food in nursing home residents
Effects of age and viscosity on food transport and breathing-swallowing coordination during eating of two-phase food in nursing home residents
复制标题
年龄和粘度对疗养院居民进食两相食物时食物输送和呼吸吞咽协调的影响
DOI：
10.1111/ggi.13056
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Ogasawara Tadashi
中科院分区：
文献类型：
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作者：
Yamada Tsuyoshi;Matsuo Koichiro;Izawa Masayuki;Yamada Shizuru;Masuda Yuji;Ogasawara Tadashi
目的进食同时含有液体和固体的食物时，液体成分经常在吞咽前进入下咽，从而增加吸入的风险。因此，我们检测了混合稠度食物的初始粘度是否会改变老年人吞咽前的食物运输和呼吸-吞咽协调。方法记录18名健康年轻人和19名老年人食用5g蒸米饭和3mL蓝染料水的纤维内窥镜检查。通过加入增稠剂(分别为0wt%，稀浆；2wt%，较稠；4wt%，较高粘度)，将液体粘度设置为三个水平。我们测量了每个参与者的吞咽开始时间及其对应的呼吸时相。结果对于稀薄的混合稠度食物，尽管年轻和老年参与者的吞咽开始时间相似，但老年人在吸气时开始吞咽的频率(31.6%)显著高于年轻参与者(5.6%)。相反，对于较稠和高粘度的食物，年龄较大的受试者吞咽开始的时间被推迟，尽管两组人在呼气时通常都会吞咽。结论在老年人中，我们观察到稀薄的混合稠度样本的吞咽起始功能被保留，但呼吸-吞咽耦合减弱。对于粘度较高的食物，吞咽的起始时间在这一组中延迟了，但呼吸-吞咽的协调没有受到干扰，这可能是因为推注流入下咽的速度很慢。因此，混合稠度食物的初始粘度似乎对养老院居民吞咽前的食物运输以及呼吸-吞咽协调有着深远的影响。Geriatr Gerontol Int 2017；17：2171-2177。
AimWhen eating food that contains both liquid and solid phases, the liquid component frequently enters the hypopharynx before swallowing and can increase the risk of aspiration. Thus, we examined whether the initial viscosity of mixed consistency food could alter pre‐swallow food transport and breathing–swallowing coordination in older adults.MethodsFiberoptic endoscopy was recorded while 18 healthy young adults and 19 older adults ate 5 g of steamed rice combined with 3 mL of blue‐dye water. Liquid viscosity was set at three levels by the addition of a thickening agent (0 wt%, thin; 2 wt%, thicker; 4 wt%, higher‐viscosity, respectively). We measured the timing of swallow initiation and its corresponding respiratory phase for each participant.ResultsFor thin mixed consistency food, whereas the timing of swallow initiation was comparable between young and older participants, swallowing was initiated during inspiration significantly more often in older participants (31.6 %) than in young participants (5.6 %). In contrast, the timing of swallow initiation was delayed in older participants for thicker and higher‐viscosity foods, although swallowing was commonly initiated during expiration in both groups.ConclusionsIn older adults, we observed that swallow initiation function was preserved for thin mixed consistency samples, but breathing–swallowing coupling was diminished. For higher‐viscosity foods, swallow initiation was delayed in this group, but breathing–swallowing coordination was not disturbed, probably as a result of the slow bolus flow into the hypopharynx. Thus, it appears the initial viscosity of mixed consistency food profoundly affects food transport before swallowing as well as breathing–swallowing coordination in nursing home residents.Geriatr Gerontol Int 2017; 17: 2171–2177.