Proactive pharyngeal swallowing exercises: Building muscular reserve in pre-frail older adults

项目概要： 吞咽食物和液体的行为是大多数人认为理所当然的基本人类功能。然而， 大约15%的老年人患有吞咽障碍，这可能导致营养不良、虚弱和 肺炎我们以前的NIH资助的研究已经证实，与年龄相关的肌肉衰退， 咽（喉）与吞咽力学和功能的负面变化有关， 成年人面临严重健康后果的风险。鉴于运动和营养是众所周知的强大 刺激积极的肌肉变化，我们建议研究这些方法，以扭转年龄相关的 咽部吞咽肌肉的衰退。具体地说，我们将测试的假设，积极主动 吞咽练习（+/-每日蛋白质补充饮料）将改善成分，力量和生理机能 咽部肌肉我们的研究设计从12周的无治疗对照开始， 我们的80名社区居住的老年人参与者作为他们自己的实验对照。接下来， 参与者将随机完成12周的咽部锻炼（每周5天）， 没有蛋白质饮料。在每个阶段之前和之后，我们的研究团队将进行一系列全面的 结果测量以量化咽肌的变化。具体来说，我们将捕获咽部 肌肉组成与磁共振成像，咽肌肉力量与高分辨率 压力测量和咽部肌肉生理学与视频荧光透视。我们认为主动吞咽 锻炼将改善咽肌的组成、力量和生理机能，并且这些收益 在+蛋白质条件下会增强。最后，我们的动机是确定与健康相关的预测因素， 治疗成功。为此，我们将评估营养状况基线指标的影响， 通过分析从血液样本中提取的生化标志物， 通过全面分析身体成分全球人口正在迅速老龄化， 许多老年人将经历吞咽受损的衰弱影响。因此研究 及时建立有效的干预措施来逆转和/或预防与年龄相关的吞咽肌肉衰退 的重大成就在吞咽肌肉中建立生理储备可以改善患者的健康和质量。 社区老年人的生活。

PROJECT SUMMARY: The act of swallowing food and liquid is a basic human function that most people take for granted. Yet, approximately 15% of older adults suffer from impaired swallowing which can lead to malnutrition, frailty and pneumonia. Our previous NIH-funded research has confirmed that age-related decline in the muscles of the pharynx (throat) is associated with negative changes to swallowing mechanics and function, putting older adults at risk for serious health consequences. Given that exercise and nutrition are known powerful stimulators of positive muscular change, we propose to investigate these methods to reverse age-related decline of the pharyngeal swallowing muscles. Specifically, we will test the hypothesis that proactive swallowing exercises (+/- daily protein supplement drinks) will improve the composition, force, and physiology of the pharyngeal muscles. Our study design begins with 12 weeks of no-treatment control, allowing each of our 80-community dwelling older adult participants to serve as their own experimental control. Next, participants will be randomized to complete 12 weeks of pharyngeal exercises (5 days per week) with or without protein drinks. Before and after each phase, our study team will conduct a comprehensive battery of outcome measures to quantify changes to the pharyngeal muscles. Specifically, we will capture pharyngeal muscle composition with magnetic resonance imaging, pharyngeal muscle force with high resolution manometry, and pharyngeal muscle physiology with videofluoroscopy. We expect that proactive swallowing exercises will improve the composition, force, and physiology of the pharyngeal muscles and that these gains will be enhanced in the +protein condition. Finally, we are motivated to identify health-related predictors of treatment success. To that end, we will assess the influence of baseline measures of nutritional status and physical function on treatment success by analyzing biochemical markers extracted from blood samples and by conducting comprehensive analyses of body composition. The global population is rapidly aging and thus many older adults will experience the debilitating impact of impaired swallowing. Therefore, research establishing effective interventions to reverse and/or prevent age-related swallowing muscle decline is timely and important. Building a physiologic reserve in the swallowing muscles can improve the health and quality of life of community-dwelling older adults.