PROGNOSTIC SIGNIFICANCE OF OROPHARYNGEAL DYSPHAGIA IN DEMENTIA PATIENTS WITH EATING DISORDERS
DOI:
https://doi.org/10.52340/jecm.2023.01.22Ключевые слова:
dementia, oropharyngeal dysphagia, eating disorders, prognosisАннотация
SUMMARY
Purpose: The purpose of the study was to study the prognostic value of OD in patients with ongoing dementia with eating disorders.
Materials and methods: 46 patients with dementia were selected for the study, 35 of whom had eating disorders. The research contingent was divided into three groups: Group 1 (n=22) - patients with eating disorders with dysphagia, Group 2 (n=13) - patients with eating disorders without dysphagia, Group 3 (n=11) - patients without eating disorders.
A minimental scale was used to assess mental status, Mental State Examination – MMSE), To evaluate the severity of the disease - clinical scale of dementia, (Clinical Dementia Rating – СDR); For assessment of the functional state – we use the test of assessment staging test - (Functional Assessment Staging Test - FAST).
The obtained results were statistically processed with computer program SPSS 24.0. Quantitative parameters were analyzed by Student's t-test, and categorical parameters by Chi2-test. p<0.05 was used as a reliability criterion.
Results: The results of the study showed that patients with dementia and eating disorders with dysphagia had statistically significantly lower MMSE scores compared to groups 2 and 3. It should also be noted that the MMSE indicators of groups 2 and 3 did not reliably differ from each other. The same trend was observed in CDR indicators. Patients with dementia and eating disorders with dysphagia had a statistically significantly higher percentage of CDR=3 compared to groups 2 and 3. It should also be noted that the indicators of CDR=3 of the 2nd and 3rd groups did not reliably differ from each other. According to the FAST indicators, there was no reliable difference in the distribution of responses between the groups.
Conclusion: OD is a common condition in patients with advanced dementia and is associated with severe complications, poor prognosis, and poor compliance with fluid and texture adaptations. Supported by the study results, we believe that new nutrition-related strategies should be developed to increase the therapeutic effect in the clinical management of patients with dementia, and new evidence should be provided for these promising interventions.
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Affoo R.H., Foley N., Rosenbek J., Kevin Shoemaker J., Martin R.E. Swallowing dysfunction and autonomic nervous system dysfunction in Alzheimer’s disease: A scoping review of the evidence. J. Am. Geriatr. Soc. 2013;61:2203–2213.
Paranji S., Paranji N., Wright S., Chandra S. A Nationwide Study of the Impact of Dysphagia on Hospital Outcomes among Patients with Dementia. Am. J. Alzheimers Dis. Dement. 2016;32:5–11.
Dementia. [(accessed on 28 February 2020)]; Available online: https://www.who.int/news-room/fact-sheets/detail/dementia
Clavé P., Shaker R. Dysphagia: Current reality and scope of the problem. Nat. Rev. Gastroenterol. Hepatol. 2015;12:259–270.
Brunnström H., Englund E. Cause of death in patients with dementia disorders. Eur. J. Neurol.2009;16:488–92.
Mitchell S.L., Teno J.M., Kiely D.K., Shaffer M.L., Jones R.N., Prigerson H.G., Volicer L., Givens J.L., Hamel M.B. The clinical course of advanced dementia. N. Engl. J. Med. 2009;361:1529–1538.
Gómez-Busto F., Andia V., De Alegria L.R., Francés I. Abordaje de la disfagia en la demencia avanzada. Revista Española de Geriatría y Gerontología. 2009;44(2):29–36.
Chouinard J. Dysphagia in Alzheimer disease: A review. J. Nutr. Heal. Aging. 2000;4:214–217.
Humbert I.A., McLaren D.G., Kosmatka K., Fitzgerald M., Johnson S., Porcaro E., Kays S., Umoh E.-O., Robbins J., Fitzgerald M. Early Deficits in Cortical Control of Swallowing in Alzheimer’s Disease. J. Alzheimers Dis. 2010;19:1185–1197.
Miarons M., Clavé P., Wijngaard R., Ortega O., Arreola V., Nascimento W., Rofes L. Pathophysiology of Oropharyngeal Dysphagia Assessed by Videofluoroscopy in Patients with Dementia Taking Antipsychotics. J. Am. Med. Dir. Assoc. 2018;19:812.e1–812.e10.
Groher M.E. Determination of the risks and benefits of oral feeding. Dysphagia. 1994;9:233–235.
Clavé P., Arreola V., et al. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin. Nutr. 2008;27:806–815.
Michel A., Vérin E., Gbaguidi X., Druesne L., Roca F., Chassagne P. Oropharyngeal Dysphagia in Community-Dwelling Older Patients with Dementia: Prevalence and Relationship with Geriatric Parameters. J. Am. Med. Dir. Assoc. 2018;19:770–774.
Espinosa-Val MC, Martín-Martínez A, et al. Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia. Nutrients. 2020 Mar; 12(3): 863.
Folstein M.F., Folstein S.E., McHugh P.R. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 1975;12:189–198.
Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. The British journal of psychiatry : the journal of mental science. 1982;140:566–72.
Reisberg B. Functional assessment staging (FAST) Psychopharmacol. Bull. 1988;24:653–659.
Jodra A.F., Ordóñez M.C., Lidón E.G., Monforte C.A. Evaluación de la actividad de una unidad de media estancia de psicogeriatria. Revista Española de Geriatría y Gerontología. 2002;37:190–197.
Cabré M., Serra-Prat M., Force L., Mir P., Palomera E., Clavé P. Oropharyngeal Dysphagia is a Risk Factor for Readmission for Pneumonia in the Very Elderly Persons: Observational Prospective Study. J. Gerontol. Ser. A Boil. Sci. Med. Sci. 2013;69:330–337.
Cabré M., Serra-Prat M., Palomera E., Mir P., Pallares R., Clavé P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing. 2009;39:39–45.
Formiga F., Fort I., Robles M.J., Barranco E., Espinosa M.C., Riu S. Medical comorbidity in elderly patients with dementia. Differences according age and gender. Revista Clínica Española. 2007;207:495–500.
Rofes L., Arreola V., Mukherjee R., Swanson J., Clavé P. The effects of a xanthan gum-based thickener on the swallowing function of patients with dysphagia. Aliment. Pharmacol. Ther. 2014;39:1169-79.
Carrión S., Cabré M., Monteis R., Roca M., Palomera E., Serra-Prat M., Rofes L., Clavé P. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital. Clin. Nutr. 2015;34:436–442.
Kossioni A. Is Europe prepared to meet the oral health needs of older people? Gerodont. 2011;29:e1230-40
Kobayashi N., Soga Y., Maekawa K., et al. Prevalence of oral health-related conditions that could trigger accidents for patients with moderate-to-severe dementia. Gerodontology. 2016;34:129–134.
Serra-Prat M., Palomera M., Gomez C., et al. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: A population-based prospective study. Age Ageing. 2012;41:376–381.
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