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健康成年人等长按压和吞咽过程中产生的压力的年龄差异。

Age-Related Differences in Pressures Generated During Isometric Presses and Swallows by Healthy Adults.

作者信息

Robbins JoAnne, Humpal Naomi S, Banaszynski Kelsey, Hind Jacqueline, Rogus-Pulia Nicole

机构信息

Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison GRECC, Room D4220, Madison, WI, 53705, USA.

Department of Medicine, School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, USA.

出版信息

Dysphagia. 2016 Feb;31(1):90-6. doi: 10.1007/s00455-015-9662-x. Epub 2015 Nov 2.

Abstract

The aim of this prospective observational study was to determine the associations among age, maximum lingual isometric pressures, and maximum swallow pressures in specific regions of the tongue. Individuals 21 years and older who reported normal swallowing were enrolled. Seventy-one healthy adults were stratified by age into young (21-40 years), middle (41-60), and old (61-82) groups. Maximum pressures were measured for each individual during isometric tongue press tasks as well as saliva, 5, and 10 mL thin liquid bolus swallows at 5 sensors located on the hard palate: front, middle, left, right, and back. Lower maximum lingual pressures for all tasks were associated with increased age (p < 0.04). Saliva pressures exhibited a different pressure pattern than bolus swallows with pressures higher than bolus swallows on middle (p < 0.03) and back (p < 0.05) tongue sensors but not in the front. Diminished swallow pressure reserve (maximum isometric pressure-maximum swallow pressure) also was found with increased age (p < 0.03). Isometric pressures were greater than swallow pressures in young and middle age groups at both the front (p < 0.04) and back (p < 0.03) sensors, but only significantly greater at the front sensor for the oldest group (p < 0.04). Older healthy adults have lower lingual isometric pressures and lower swallow pressures than younger healthy adults. Elders have a decreased swallow pressure reserve to draw upon during occasions of physiological stress. While the exact mechanisms for age-related decline in lingual pressures remain unclear, they are likely due, at least in part, to sarcopenia. Saliva, 5, and 10 mL thin boluses also exhibit different age-related declines in pressure at specific sensors, indicating they may elicit different muscle activation patterns.

摘要

这项前瞻性观察性研究的目的是确定年龄、最大舌等长压力以及舌特定区域的最大吞咽压力之间的关联。纳入了21岁及以上且报告吞咽正常的个体。71名健康成年人按年龄分为青年组(21 - 40岁)、中年组(41 - 60岁)和老年组(61 - 82岁)。在等长舌压任务期间,以及在位于硬腭的5个传感器(前部、中部、左侧、右侧和后部)处吞咽唾液、5毫升和10毫升稀液体团块时,测量每个个体的最大压力。所有任务的最大舌压力较低与年龄增加相关(p < 0.04)。唾液压力呈现出与团块吞咽不同的压力模式,在中部(p < 0.03)和后部(p < 0.05)舌传感器处的压力高于团块吞咽,但在前部并非如此。随着年龄增加,吞咽压力储备(最大等长压力 - 最大吞咽压力)也降低(p < 0.03)。在青年组和中年组中,前部(p < 0.04)和后部(p < 0.03)传感器处的等长压力均大于吞咽压力,但在最年长组中,仅前部传感器处的等长压力显著更大(p < 0.04)。与年轻健康成年人相比,年长健康成年人的舌等长压力和吞咽压力更低。老年人在生理应激情况下可利用的吞咽压力储备减少。虽然舌压力随年龄下降的确切机制尚不清楚,但它们可能至少部分归因于肌肉减少症。唾液、5毫升和10毫升稀团块在特定传感器处也呈现出不同的与年龄相关的压力下降,表明它们可能引发不同的肌肉激活模式。

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