Department of Otolaryngology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.
Department of Otolaryngology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.
Auris Nasus Larynx. 2020 Aug;47(4):602-608. doi: 10.1016/j.anl.2020.02.004. Epub 2020 Feb 19.
The risk of aspiration pneumonia has been reported to increase with age, especially in elderly residents of nursing homes. However, the characteristics of those with swallowing impairments at elderly care facilities have not yet been evaluated using reliable instrumental examinations. The aims of the current study were to investigate the frequency of swallowing impairment and determine the characteristics of the elderly with swallowing disorders residing at care facilities.
To reveal the characteristics of the elderly with swallowing disorders, questionnaires for dysphagia screening and flexible endoscopic evaluation of swallowing (FEES) were used. Regarding the dysphagia screening, two types of questionnaires were sent to 451 elderly persons aged 65 years and older who were living in facilities for the elderly in Japan. FEES was performed to assess swallowing impairment at each facility for those who were found to be positive for dysphagia by the questionnaires. The frequency of swallowing impairment and the characteristics of elderly subjects with swallowing disorders were investigated.
Among 413 subjects who completed both questionnaires, 229 were screened positive for dysphagia, 160 of whom underwent FEES. Swallowing impairment was observed in 93 subjects. The subjects with swallowing impairment had a significantly high prevalence of fever, sputum, and/or history of aspiration pneumonia. Their oral intake ability and activities of daily living were significantly low.
We demonstrated the frequency of swallowing disorders and the characteristics of elderly subjects with swallowing disorders living in care facilities using FEES. Our results suggest the importance of screening all elderly care facility residents for dysphagia.
据报道，吞咽困难的风险随着年龄的增长而增加，尤其是在养老院的老年居民中。然而，使用可靠的仪器检查尚未评估老年人护理机构中存在吞咽障碍的患者的特征。本研究的目的是调查吞咽障碍的频率，并确定居住在护理机构的吞咽障碍老年人的特征。
为了揭示吞咽障碍老年人的特征，使用了吞咽障碍筛查问卷和灵活的内镜吞咽评估（FEES）。对于吞咽障碍筛查，向日本 451 名 65 岁及以上居住在养老院的老年人发送了两种类型的问卷。对于通过问卷筛查出吞咽障碍阳性的患者，在每个设施进行 FEES 以评估吞咽障碍。调查吞咽障碍的频率以及吞咽障碍老年人的特征。
在完成两份问卷的 413 名受试者中，229 名被筛查出吞咽障碍阳性，其中 160 名接受了 FEES。93 名受试者存在吞咽障碍。存在吞咽障碍的受试者发热、咳痰和/或有吸入性肺炎史的比例显著较高，其口腔摄入能力和日常生活活动能力显著较低。
我们使用 FEES 展示了在护理机构中吞咽障碍的频率和吞咽障碍老年人的特征。我们的研究结果表明，对所有老年护理机构的居民进行吞咽障碍筛查非常重要。
