Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan.
Department of Speech and Hearing Sciences, International University of Health and Welfare, Narita, Japan.
Geriatr Gerontol Int. 2019 Feb;19(2):91-97. doi: 10.1111/ggi.13591. Epub 2019 Jan 9.
This report was written by the Japanese Society of Dysphagia Rehabilitation, the Japanese Association of Rehabilitation Nutrition, the Japanese Association on Sarcopenia and Frailty, and the Society of Swallowing and Dysphagia of Japan to consolidate the currently available evidence on the topics of sarcopenia and dysphagia. Histologically, the swallowing muscles are of different embryological origin from somatic muscles, and receive constant input stimulation from the respiratory center. Although the swallowing muscles are striated, their characteristics are different from those of skeletal muscles. The swallowing muscles are inevitably affected by malnutrition and disuse; accumulating evidence is available regarding the influence of malnutrition on the swallowing muscles. Sarcopenic dysphagia is defined as dysphagia caused by sarcopenia of the whole body and swallowing-related muscles. When sarcopenia does not exist in the entire body, the term "sarcopenic dysphagia" should not be used. Additionally, sarcopenia due to neuromuscular diseases should be excluded; however, aging and secondary sarcopenia after inactivity, malnutrition and disease (wasting disorder and cachexia) are included in sarcopenic dysphagia. The treatment of dysphagia due to sarcopenia requires both dysphagia rehabilitation, such as resistance training of the swallowing muscles and nutritional intervention. However, the fundamental issue of how dysphagia caused by sarcopenia of the swallowing muscles should be diagnosed remains unresolved. Furthermore, whether dysphagia can be caused by primary sarcopenia should be clarified. Additionally, more discussion is required on issues such as the relationship between dysphagia and secondary sarcopenia, as well as the diagnostic criteria and means for diagnosing dysphagia caused by sarcopenia. Geriatr Gerontol Int 2019; 19: 91-97.
本报告由日本吞咽障碍康复学会、日本康复营养学会、日本肌肉减少症和虚弱学会以及日本吞咽障碍学会共同撰写，旨在整合目前关于肌肉减少症和吞咽障碍相关主题的证据。从组织学上看，吞咽肌肉与躯体肌肉具有不同的胚胎起源，且持续接受来自呼吸中枢的输入刺激。尽管吞咽肌肉具有横纹，但它们的特征与骨骼肌不同。吞咽肌肉不可避免地受到营养不良和废用的影响；目前已有大量证据表明营养不良对吞咽肌肉的影响。全身肌肉减少症和吞咽相关肌肉所致的吞咽障碍定义为肌肉减少症性吞咽障碍。当全身不存在肌肉减少症时，不应使用“肌肉减少症性吞咽障碍”这一术语。此外，应排除由神经肌肉疾病引起的肌肉减少症；然而，包括与年龄相关的肌肉减少症以及因缺乏活动、营养不良和疾病（消耗性疾病和恶病质）导致的继发性肌肉减少症。肌肉减少症性吞咽障碍的治疗需要吞咽障碍康复，如吞咽肌肉的抗阻训练和营养干预。然而，如何诊断由吞咽肌肉肌肉减少症引起的吞咽障碍这一根本问题仍未得到解决。此外，还需要明确是否由原发性肌肉减少症引起吞咽障碍。此外，还需要进一步讨论吞咽障碍与继发性肌肉减少症之间的关系，以及诊断由肌肉减少症引起的吞咽障碍的标准和方法。《老年医学与老年病学国际杂志》2019 年；19:91-97。
