Nimmons Danielle, Michou Emilia, Jones Maureen, Pendleton Neil, Horan Michael, Hamdy Shaheen
Faculty of Medical and Human Sciences, Centre for Gastrointestinal Sciences, Institute of Inflammation and Repair, University of Manchester, Salford Royal NHS Foundation Trust, Clinical Sciences Building, Manchester, M6 8HD, UK.
Centre for Integrated Genomic Medical Research, Manchester, UK.
Dysphagia. 2016 Aug;31(4):560-6. doi: 10.1007/s00455-016-9715-9. Epub 2016 Jun 15.
Dysphagia has been estimated to affect around 8-16 % of healthy elderly individuals living in the community. The present study investigated the stability of perceived dysphagia symptoms over a 3-year period and whether such symptoms predicted death outcomes. A population of 800 and 550 elderly community-dwelling individuals were sent the Sydney Swallow Questionnaire (SSQ) in 2009 and 2012, respectively, where an arbitrary score of 180 or more was chosen to indicate symptomatic dysphagia. The telephone interview cognitive screen measured cognitive performance and the Geriatric Depression Scale measured depression. Regression models were used to investigate associations with dysphagia symptom scores, cognition, depression, age, gender and a history of stroke; a paired t test was used to examine if individual mean scores had changed. A total of 528 participants were included in the analysis. In 2009, dysphagia was associated with age (P = 0.028, OR 1.07, CI 1.01, 1.13) and stroke (P = 0.046, OR 2.04, CI 1.01, 4.11) but these associations were no longer present in 2012. Those who had symptomatic dysphagia in 2009 (n = 75) showed a shift towards improvement in swallowing (P < 0.001, mean = -174.4, CI -243.6, -105.3), and for those who died from pneumonia, there was no association between the SSQ derived swallowing score and death (P = 0.509, OR 0.10, CI -0.41, -0.20). We conclude that swallowing symptoms are a temporally dynamic process, which increases our knowledge on swallowing in the elderly.
据估计，吞咽困难影响着约8% - 16%居住在社区的健康老年人。本研究调查了3年期间感知到的吞咽困难症状的稳定性，以及这些症状是否能预测死亡结果。分别在2009年和2012年向800名和550名社区老年居民发放了悉尼吞咽问卷（SSQ），选择180分及以上的任意分数来表明有症状的吞咽困难。电话访谈认知筛查测量认知能力，老年抑郁量表测量抑郁情况。使用回归模型研究与吞咽困难症状评分、认知、抑郁、年龄、性别和中风病史之间的关联；使用配对t检验来检查个体平均分数是否发生了变化。共有528名参与者纳入分析。2009年，吞咽困难与年龄（P = 0.028，OR 1.07，CI 1.01，1.13）和中风（P = 0.046，OR 2.04，CI 1.01，4.11）相关，但这些关联在2012年不再存在。2009年有症状性吞咽困难的人（n = 75）吞咽情况有改善趋势（P < 0.001，均值 = -174.4，CI -243.6，-105.3），对于死于肺炎的人，SSQ得出的吞咽分数与死亡之间无关联（P = 0.509，OR 0.10，CI -0.41，-0.20）。我们得出结论，吞咽症状是一个随时间变化的动态过程，这增加了我们对老年人吞咽情况的了解。
