Lin Ting-Fen, Shune Samantha
Communication Disorders and Sciences Program, University of Oregon, Eugene, OR 97403, USA.
Geriatrics (Basel). 2020 Aug 24;5(3):45. doi: 10.3390/geriatrics5030045.
Chronic obstructive pulmonary disease (COPD) is a leading global cause of death and disability. The literature has previously established clear physiological characteristics of COPD-related dysphagia (swallowing difficulties). However, COPD and dysphagia are both also intimately tied to breathing and contribute to a cascade of secondary physio-psycho-emotional sequalae, such as COPD exacerbation, anxiety, depression, increased economic burden, social isolation, and decreased quality of life. Further, the collective impact of these comorbidities may magnify disease impact, resulting in a downward spiral of well-being. Thus, the clinical relevance of COPD's and dysphagia's frequently occurring and overlapping sequelae cannot be overlooked, as the disease-related burden of both disorders is deeply rooted in the presence of concomitant physiological and psycho-emotional consequences. The current review explores the complex network of interactions between COPD, dysphagia, and their outcomes, framing this relationship within a mind-body-breath framework. Ultimately, we propose a model that more comprehensively captures the constellation of interrelated disease characteristics and consequences, highlighting a need for researchers and healthcare providers to consider disease impact more broadly in order to maximize treatment outcomes.
慢性阻塞性肺疾病(COPD)是全球主要的死亡和致残原因。此前的文献已经明确了COPD相关吞咽困难(吞咽障碍)的生理特征。然而,COPD和吞咽困难都与呼吸密切相关,并导致一系列继发性生理 - 心理 - 情感后果,如COPD急性加重、焦虑、抑郁、经济负担增加、社会隔离以及生活质量下降。此外,这些合并症的共同影响可能会放大疾病的影响,导致健康状况呈螺旋式下降。因此,COPD和吞咽困难常见且重叠的后果的临床相关性不容忽视,因为这两种疾病相关的负担深深植根于伴随的生理和心理 - 情感后果之中。本综述探讨了COPD、吞咽困难及其后果之间复杂的相互作用网络,将这种关系置于身心呼吸框架内。最终,我们提出了一个模型,该模型更全面地捕捉了相互关联的疾病特征和后果的组合,强调研究人员和医疗保健提供者需要更广泛地考虑疾病影响,以最大限度地提高治疗效果。