Swallowing disorders in nursing home residents: how can the problem be explained?
Swallowing disorders in nursing home residents: how can the problem be explained?
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DOI：
10.2147/cia.s39452
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发表时间：
2013
影响因子：
3.6
通讯作者：
Reis E
中科院分区：
文献类型：
--
作者：
Nogueira D;Reis E
即使没有慢性疾病，吞咽机制也会随着人们年龄的增长而发生显着变化。老食症是一个术语，指的是吞咽机制中与衰老相关的变化，可能与许多健康状况有关，并以不同的方式表现出来。吞咽障碍也被认为是居住在疗养院的老年人口中的一个主要问题。该研究旨在确定疗养院居民吞咽障碍的患病率，确定自我感知的吞咽障碍、认知功能、自主性和抑郁之间的关系，并分析哪些变量可以解释吞咽困难自测（DST）的得分。为此，研究人员选择进行一项调查，传达有关人口统计、一般健康、饮食和喂养的问题，以及评估功能表现的仪器和 3 盎司吞水测试。样本包括居住在葡萄牙八个疗养院的 272 名老年人。六人未签署知情同意书。其中，29% 的人完全依赖他人，33% 的人感到抑郁，45% 的人有认知障碍，38% 的人需要喂养帮助。大约 43% 的人表示存在与饮食相关的问题。关于 DST，40% 的人表现出吞咽困难的迹象。在 3 盎司吞水测试中，38% 的人至少表现出一种症状，其中湿嗓是最常见的。相关性测量显示，年龄与 DST 分数没有线性相关，尽管与 Barthel 指数和简易精神状态检查有显着相关性。以 DST 分数作为因变量，以 MMSE 和 BI 分数、性别、年龄、教育程度、老年抑郁量表分数、3 盎司吞水测试和诊断状况（如神经系统疾病、痴呆和心肺问题）作为解释变量来估计线性回归模型。结果显示，疗养院人群中吞咽困难症状的患病率很高。出于本研究的目的，采用了主观和客观评估。结果表明，客观测量和主观测量之间存在显着的统计关系，因此表明自我感知测试应纳入疗养院人群吞咽障碍的评估中。尽管如此，它不应该被用作单一或主要的衡量标准，因为它受到个人认知状况的影响。
The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes. The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST). For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test. The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age, education, the Geriatric Depression Scale score, 3 ounce Water Swallow Test, and diagnosed conditions (such as neurological disorder, dementia, and cardiorespiratory problems) as explaining variables. Results showed a high prevalence of dysphagia signs amongst a nursing home population. For the purpose of the present study, both a subjective and an objective assessment were applied. Results pointed to a significant statistical relation between objective and subjective measures, thus indicating that a self-perception test should be included in the assessment of swallowing disorders in a nursing home population. Notwithstanding, it should not be used as a single or principal measure as it is influenced by the individuals’ cognitive condition.