Multidisciplinary study on the organ interrelation between swallowing and regulation of respiration for furthering the quqlity of life in the elderly

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The results of multidisciplinary study on the relationship between swallowing and regulation of respiration for three years are summarized as follows ; 1) Aspiration pulmonary diseases (APD) were found in more than 2 % of all elderly inpatients in general hospitals. 2) Cerebrovascular diseases, dementia and malignancies are common background diseases, and impairment of active daily life is the most important risk factor of APD.3) The new techniques such as swallowing provocation test (SPT) and manofluorgrapy (MF) are quantitative and reproducible tests for assessment of swallowing function, and are useful for early detection of high-risk patients with APD.They are also helpful for the assessment of therapeutic effectiveness of APD.4) Swallowing appears to be regulated by multiple cerebral regions including bilateral operculum, insula and basal ganglia, and these regions may cooperate in conjunction with brain stem central program generation of deglutition. 5) SPT is helpful to assess t … More he function of second phase of swallowing, and correlates with the bolus passage time in MF.6) SPT and MF are so sensitive for evaluation of swallowing that impaiment by aging is frequently found even in the healthy elderly. 7) The effectiveness of optimal regulation of dietary contents and frequency is verified by evaluating the patients with dysphasia using MF.8) Prospective study revealed that the patients with abnormal SPT findings are predicted to haveaa higher martality rate of aspiration pneumonia. 9) Clinical entity of APD was established and nation-wide surveillance for diffuse aspiration bronchiolitis (DAB) was carried out. The study revealed DAB is found through out the country, and occurs even in younger patients. 10) It is verified that APD is one of important prognostic factors in patients with systemic sclerosis (SSc). 11) Esophagus scores, a new indicator of aspiration in SSc, may be useful for early detection and propylaxic prevention of APD.12) Percutaneous endoscopic gastrostomy (PEG) is confirmed as an effective therapeutic intervention regarding nutritional maintenance and prevention of APD.These observations revealed close organ interrelation between swallowing and respiratory system and confirmed the significance of its understanding to promote quality of life in the elderly. Less