Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
Universidade de São Paulo, Departamento de Fonoaudiologia e Terapia Ocupacional, São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2021 Jan;79(1):8-14. doi: 10.1590/0004-282X20200060.
Swallowing and feeding problems may occur with the progression of behavioral variant frontotemporal dementia (bvFTD) and can impair the anticipatory and oral preparatory phases of swallowing.
To characterize swallowing problems and the feeding situation of patients with bvFTD and to correlate the swallowing problems with functionality, executive functions, cognitive and behavioral features.
Consecutive outpatients with bvFTD in mild, moderate and severe dementia stages were recruited along with their caregivers. Patients and caregivers were screened with the following scales: "Mini-Mental State Examination", "Severe Mini-Mental State Examination", "FTLD-modified Clinical Dementia Rating", "Neuropsychiatric Inventory", "Frontal Assessment Battery", "Index of Independence in Activities of Daily Living", "Swallowing Rating Scale" and "Assessment of Feeding and Swallowing Difficulties in Dementia".
Overall, thirty patients with bvFTD were included along with their caregivers. Patients with bvFTD showed feeding and swallowing difficulties such as: messy to eat, passivity, coughing and choking, difficulty with some food consistencies and with specific food. Swallowing problems in bvFTD correlated with impaired functionality (p<0.05) and cognition (p<0.05), executive dysfunction (p<0.01) and behavioral features (p<0.01). Caregivers had great difficulty in managing the feeding situation during mealtime, with different characteristics in each dementia stage.
Patients with bvFTD had inappropriate speed eating, passivity, coughing and choking starting in the mild dementia stage, and these problems worsen in the severe stage. Such difficulties affected caregiver performance during mealtime. The correlations indicated that swallowing difficulties tend to follow cognitive and behavioral decline in patients with bvFTD.
行为变异额颞叶痴呆（bvFTD）的进展可能会出现吞咽和进食问题，并会损害吞咽的预期和口腔准备阶段。
描述 bvFTD 患者的吞咽问题和喂养情况，并将吞咽问题与功能、执行功能、认知和行为特征相关联。
连续招募轻度、中度和重度痴呆阶段的 bvFTD 门诊患者及其照顾者。对患者和照顾者进行以下量表筛查：“简易精神状态检查”、“严重简易精神状态检查”、“FTLD 改良临床痴呆评定量表”、“神经精神问卷”、“额叶评定量表”、“日常生活活动独立性指数”、“吞咽评定量表”和“痴呆患者喂养和吞咽困难评估”。
共有 30 名 bvFTD 患者及其照顾者纳入研究。bvFTD 患者表现出喂养和吞咽困难，例如：进食时弄得到处都是、被动、咳嗽和呛噎、难以进食某些食物质地和特定食物。bvFTD 的吞咽问题与功能受损（p<0.05）和认知（p<0.05）、执行功能障碍（p<0.01）和行为特征（p<0.01）相关。在进餐时，照顾者在管理喂养情况方面存在很大困难，不同痴呆阶段有不同的特征。
bvFTD 患者在轻度痴呆阶段就出现进食速度不当、被动、咳嗽和呛噎等问题，这些问题在重度痴呆阶段会加重。这些困难影响了照顾者在进餐时的表现。相关性表明，吞咽困难往往随着 bvFTD 患者认知和行为的下降而出现。
