Effects of Aging on Anticipatory Functional Synergies Activated in Deglutition

描述(由申请人提供)：该项目的总体目标是帮助了解整个进食过程中与年龄相关的生理和功能变化，从而为有吞咽问题的个人设计更有效的治疗方法，特别是在老龄化人口中。在许多老年人中常见的认知、身体和感觉障碍的组合，特别是在存在共病神经损害(例如痴呆症)的情况下，往往导致饮食需求得不到满足，导致发病率和过早死亡的增加。这些人中的许多人的功能受限，需要在食用食物和液体方面提供广泛或全面的援助。然而，尽管与辅助喂养相关的安全性增加，但这一建议导致的线索(例如，手/手臂的本体感觉)对已经征税的系统的影响和潜在增加的风险尚不清楚。关于这些口前或预见性的暗示和刺激在“安全饮食和吞咽”过程中的作用，文献资料有限。为了解决这个与临床相关的问题，这个项目试图：(1)确定年轻人和老年人在口前吞咽阶段涉及手/手臂、嘴唇和下巴的协同肌肉模式；(2)确定非口咽感觉信息的修改和反馈对年轻人和老年人启动和改变这些口腔运动模式的影响。这一建议的实验方法利用了利用肌电和光学运动检测技术来检查在典型的进食和吞咽过程中发生的预期反应和纠错模式中与年龄相关的变化的机会。这项工作意义重大，因为吞咽和吞咽前计划的预期阶段的中断不仅在需要喂养帮助的个人亚群中很常见，而且在患有许多神经疾病的个人中也很突出，包括痴呆症、右半球障碍、中风和创伤性脑损伤。在这项研究中获得的知识将有助于将正常衰老的影响与这些疾病造成的影响分开，这对设计适当的评估和干预技术很重要。确定吞咽预期阶段的感觉反馈中断是否会影响以后吞咽的模式和时间，然后可能导致开发新的有效喂养方法和吞咽策略，旨在预防老年人和临床人群的吞咽困难和上呼吸道损害。 公共卫生相关性：吞咽问题导致与疾病相关的高昂的经济、身体和心理社会成本，特别是在老年人中。尽管对这些人的喂养辅助意味着增加了安全性，但缺乏口前感觉提示对已经征税的系统的影响和潜在风险尚不清楚。通过研究这些口腔前暗示与健康老年人进食和吞咽过程中预期的口腔姿势之间的关系，这项研究旨在解决这些建议可能导致的风险增加的可能性，加强与吞咽相关的做法和干预。

DESCRIPTION (provided by applicant): The overall goal of this project is to contribute to the understanding of the age-related physiological and functional changes that occur across the eating process, leading to the design of more efficacious treatments for individuals with swallowing problems, particularly in the aging population. The combination of cognitive, physical, and sensory impairments commonly seen in many elderly individuals, especially in the presence of co-morbid neurologic impairment (e.g., dementia), often results in eating needs going unmet, leading to increased morbidity and premature mortality. The functional limitations of many of these individuals necessitate extensive or total assistance with consuming foods and liquids. However, despite the implication of increased safety associated with assisted feeding, the influence and potential increased risk of the elimination of cues resulting from this recommendation (e.g., proprioception from the hand/arm) on an already taxed system are unclear. Limited literature is available regarding the contribution of these pre-oral, or anticipatory, cues and stimuli to the process of "safe eating and swallowing". To address this clinically-relevant problem, this project seeks to: (1) identify the synergistic muscle patterns involving the hand/arm, lips, and jaw that are present during the pre-oral stage of deglutition in younger and older adults; and (2) to determine the influence of modifications in non-oropharyngeal sensory information and feedback on initiating and altering these oral motor patterns in younger and older adults. The experimental approach of this proposal capitalizes on the opportunity to utilize electromyography and optical motion detection techniques to examine the age-related changes in anticipatory responses and error correction patterns that occur during typical eating and swallowing. This work is significant as disruptions in the anticipatory stage of swallowing and pre-swallowing planning are common not only in the subpopulation of individuals requiring feeding assistance, but are additionally prominent in individuals with numerous neurological diseases, including dementia, right hemisphere disorder, stroke, and traumatic brain injury. The knowledge gained in this study will help disassociate the effects of normal aging from those due to these diseases, important in the design of appropriate assessment and intervention techniques. Determining whether or not disruptions in sensory feedback during the anticipatory stage of swallowing affect the pattern and timing of later swallowing may then lead to the development of new approaches to effective feeding practices and swallowing strategies aimed at preventing dysphagia and upper airway compromise in the elderly and across clinical populations. PUBLIC HEALTH RELEVANCE: Swallowing problems contribute to the high financial, physical, and psychosocial costs associated with disease, particularly in the elderly. Despite the implication of increased safety associated with feeding assistance for these individuals, the influence and potential risks of absent pre-oral sensory cues on an already taxed system are unclear. By examining the relationship between these pre-oral cues and anticipatory oral posturing during eating and swallowing in healthy elderly individuals, this research is positioned to address the potential for increased risk these recommendations may elicit, enhancing swallowing-related practices and interventions.