Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults
Development and Predictors of Sarcopenic Dysphagia during Hospitalization of Older Adults
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DOI：
10.3390/nu12010070
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发表时间：
2020-01-01
期刊：
影响因子：
5.9
通讯作者：
Mori, Naoharu
中科院分区：
文献类型：
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作者：
Maeda, Keisuke;Ishida, Yuria;Mori, Naoharu
本研究旨在探讨住院期间肌肉减少症和肌肉减少症相关疾病对吞咽障碍发展的影响。研究发病前无吞咽障碍的老年住院患者（n = 8768）。通过营养状况、身体状况和活动状况评估骨骼肌减少症相关情况，并通过小腿围评估手部握力和肌肉质量。吞咽障碍的发展是根据出院时的食物质地来确定的。患者平均年龄为76.1±6.9岁。共有374例（4.3%）患者在住院期间出现吞咽障碍。与没有吞咽障碍的人相比，他们年龄更大，营养状况更差，身体机能下降更多。多因素分析中，表现状态评分(优势比（OR) = 1.28 (1.12-1.46) p < 0.001）、卧床依赖（OR = 1.72 (1.09-2.71), p = 0.020）、营养不良评分（OR = 0.92 (0.87-0.97), p = 0.002）、营养摄入不足（OR = 2.33 (1.60-3.40), p < 0.001）、住院时间（OR = 1.01 (1.00-1.01), p = 0.001）是吞咽障碍发生的独立影响因素。可能出现的肌肉减少症也是导致吞咽障碍发展的一个因素。综上所述，住院期间可能出现肌肉减少症和肌肉减少相关疾病的患者可能出现吞咽障碍。临床医生应该意识到这种风险，并提供适当的干预措施来预防肌肉减少性吞咽困难。
The study aimed to investigate the impact of sarcopenia and sarcopenia-related conditions on the development of swallowing disorders during hospitalization. Older adult inpatients (n = 8768) without swallowing disorders in the premorbid period were studied. Sarcopenia-related conditions were evaluated in terms of nutritional status, physical status, and ambulatory conditions as well as hand-grip strength and muscle mass assessed by calf circumference. Development of swallowing disorders was defined based on food texture at discharge from the hospital. The patients' mean age was 76.1 +/- 6.9 years. A total of 374 (4.3%) patients developed swallowing disorders during hospitalization. They were older, with poorer nutritional status, and had more decline of physical performance than those without swallowing disorders. Performance Status score (odds ratio (OR) = 1.28 (1.12-1.46) p < 0.001), ambulatory dependency (OR = 1.72 (1.09-2.71), p = 0.020), malnutrition score (OR = 0.92 (0.87-0.97), p = 0.002), insufficient nutritional intake (OR = 2.33 (1.60-3.40), p < 0.001), and length of stay (OR = 1.01 (1.00-1.01), p = 0.001) were independent contributing factors for swallowing disorder development in the multivariate analysis. The presence of possible sarcopenia was also a contributor to swallowing disorder development. In conclusion, swallowing disorders could develop in patients with possible sarcopenia and sarcopenia-related conditions during hospitalization. Clinicians should be aware of this risk and provide appropriate interventions to prevent sarcopenic dysphagia.