Exploring the relationship between age-related pharyngeal atrophy and difficulty swallowing.

探讨年龄相关性咽部萎缩与吞咽困难之间的关系。

• 批准号: 9019209
• 负责人: Sonja M Molfenter
• 金额: $ 25.15万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-12-01 至 2017-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9019209
• 关键词: Acoustics; Adopted; Age; Aging; Aging-Related Process; Aspiration Pneumonia; Atrophic; Back; Biomechanics; Bolus Infusion; Clinical; Communities; Data; Deglutition; Deglutition Disorders; Dehydration; Dental; Dental Research; Development; Eating; Elderly; Ensure; Event; Exercise; Foundations; Funding; Future; Health; Height; Hospitals; Human; Hydration status; Impairment; Individual; Intervention Studies; Isometric Exercise; Knowledge; Length of Stay; Life; Literature; Long-Term Care; Magnetic Resonance Imaging; Malnutrition; Measures; Methods; Monitor; Muscular Atrophy; Neck; Oral cavity; Oropharyngeal; Outcome; Participant; Patients; Pharyngeal structure; Pneumonia; Population; Prevalence; Prevention; Preventive Intervention; Protocols documentation; Quality of life; Rehabilitation therapy; Research; Respiration; Risk; Sampling; Science; Sleep; Societies; Technology; Tongue; Variant; Work; age related; age-related muscle loss; base; combat; constriction; cost; drinking; exercise rehabilitation; experience; frailty; healthy aging; improved; innovation; muscle form; novel; nutrition; older women; pharynx muscle; pressure; prevent; programs; public health relevance; sarcopenia; skeletal; social; sonar; sound; tool; young woman

 DESCRIPTION (provided by applicant): Safe and efficient swallowing is something that most people take for granted. However, a disruption to swallowing function (dysphagia) is not uncommon in the aging process and can have serious consequences for one's health (nutrition, hydration, pneumonia) and quality-of-life. Studies suggest that the prevalence of swallowing disorders in older individuals ranges from 15-74%, depending on the population sampled and/or the metric used to define dysphagia. Sarcopenia is the age-related loss of skeletal muscle mass, organization, and strength and is a widely-cited explanation for age-related decline in swallow function. Our recent research confirms that age-related muscle loss occurs in the pharynx (throat) alongside an associated increase in pharyngeal lumen (throat cavity) volume. It is unknown how this increase in pharyngeal volume impacts swallowing biomechanics and function. The long-term objective of this research is to establish a relationship between the extent of pharyngeal sarcopenia (represented by larger pharyngeal lumen volume) and swallowing impairment. The central hypothesis of this proposal is that greater pharyngeal lumen volume will be associated with impaired swallowing biomechanics (pharyngeal constriction and shortening) and function (post-swallow residue). A novel application of Acoustic Reflection Technology (ART) will provide the innovative method to non-invasively measure pharyngeal lumen volume. Adopted from sleep science and dental research, ART functions similar to sonar. Sound waves are introduced into the mouth and throat and are reflected back to a microphone. Based on the acoustic reflection, a representation of the pharyngeal lumen can be calculated. ART measures of pharyngeal volume will be compared with biomechanical and functional measures of swallowing using a standardized videofluoroscopy (VF) protocol. This same VF protocol will also yield the data to establish the efficacy of a pharyngeal maneuver, called the Effortful Swallow (ES), to improve swallowing biomechanics and function. We expect to find that the ES improves measures of pharyngeal constriction, pharyngeal shortening and residue compared with regular swallows from the same individual. This data will provide the foundation for a future exercise-based intervention/prevention study using the ES to combat pharyngeal muscle loss. The proposed research is significant and timely. As the mean age of our population rapidly shifts upwards, it is critical to understand how, when and why natural aging of the swallowing mechanism transforms into a swallowing disorder. It is anticipated that this work will establish the following; (1) an inverse relationship between pharyngeal lumen volume and swallowing biomechanics and function, (2) the utility of the ES to improve swallowing biomechanics and function and (3) the value of ART to monitor age- related change in the pharynx. Together this will inform a future program of research on the prevention/rehabilitation of pharyngeal sarcopenia.

 描述（由申请人提供）：大多数人认为安全有效的吞咽是理所当然的。然而，吞咽功能的破坏（吞咽困难）在衰老过程中并不罕见，并且可能对人的健康（营养、水分、肺炎）和生活质量产生严重后果。研究表明，老年人吞咽障碍的患病率为 15-74%，具体取决于抽样人群和/或用于定义吞咽困难的指标。肌肉减少症是与年龄相关的骨骼肌质量、组织和力量的损失，是与年龄相关的吞咽功能下降的一个被广泛引用的解释。我们最近的研究证实，与年龄相关的肌肉损失发生在咽部（喉咙），同时咽腔（喉咙腔）体积也随之增加。目前尚不清楚咽部体积的增加如何影响吞咽生物力学和功能。这项研究的长期目标是建立咽肌减少症的程度（以较大的咽腔体积为代表）与吞咽障碍之间的关系。该提议的中心假设是，更大的咽腔体积与吞咽生物力学（咽部收缩和缩短）和功能（吞咽后残留物）受损有关。声反射技术（ART）的新颖应用将为非侵入性测量咽腔体积提供创新方法。 ART 源自睡眠科学和牙科研究，其功能类似于声纳。声波被引入口腔和喉咙并反射回麦克风。基于声反射，可以计算咽腔的表示。将使用标准化视频荧光镜检查 (VF) 方案将咽部容积的 ART 测量值与吞咽的生物力学和功能测量值进行比较。同样的 VF 协议还将产生数据来确定咽部操作（称为“努力吞咽”（ES））的功效，以改善吞咽生物力学和功能。我们期望发现，与同一个体的常规吞咽相比，ES 改善了咽部收缩、咽部缩短和残留的测量。这些数据将为未来使用 ES 对抗咽部肌肉损失的基于运动的干预/预防研究奠定基础。拟议的研究意义重大且及时。随着人口平均年龄迅速上升，了解吞咽机制的自然衰老如何、何时以及为何转变为吞咽障碍至关重要。预计这项工作将建立以下内容： (1) 咽腔体积与吞咽生物力学和功能之间的反比关系，(2) ES 在改善吞咽生物力学和功能方面的效用，以及 (3) ART 在监测咽部与年龄相关的变化方面的价值。这将为未来预防/康复咽肌减少症的研究计划提供信息。