Department of Otolaryngology, SUNY Downstate Medical Center, 450 Clarkson Avenue, MSC 126, Brooklyn, NY, 11203-2012, USA.
SUNY Downstate- School of Medicine, Brooklyn, NY, USA.
Dysphagia. 2022 Oct;37(5):1093-1102. doi: 10.1007/s00455-021-10371-8. Epub 2021 Sep 17.
Sarcopenic dysphagia (SD) is swallowing difficulty associated with loss of generalized skeletal muscles and swallowing-related muscles. Diagnostic criteria for SD were suggested, yet there is a variability in instruments and cut-offs used. The aim of the current review is to critically evaluate tools used in diagnosis of sarcopenic dysphagia in the elderly. Comprehensive review of the literature was performed. Studies were qualitatively evaluated for the diagnostic tools used to make a diagnosis of "sarcopenic dysphagia" and compared to the known diagnostic criteria for SD and other accepted measures. Fourteen studies (N = 10,282) were selected from a search yield of 331 de-duplicated studies. Ninety-three percent of studies (13/14) were conducted in Japan. All subjects included were over the age of 65 years old (mean, 76.5 years). Various tools were used to assess sarcopenia including handgrip strength (14/14 of studies), followed by skeletal muscle mass/index (7/14), tongue pressure, gait speed, and calf circumference in 5/14 studies. The most commonly tool used for dysphagia and/or swallowing dysfunction was the food level intake scale (5/14 of studies) followed by the functional oral intake scale (3/14). The 100-mL water swallow test was used in 2 of the 14 included SD studies. Fiberoptic endoscopic evaluation of swallowing, videofluoroscopic swallowing study, EAT-10 questionnaire, and standardized swallow assessment were each used in only one SD study. Further research is required to validate SD diagnostic tools, establish cut-offs in different populations, and investigate their role in screening of dysphagia and swallowing dysfunction in the elderly.
肌肉减少性吞咽困难（SD）是一种与全身骨骼肌和吞咽相关肌肉丧失相关的吞咽困难。已经提出了 SD 的诊断标准，但用于诊断的仪器和截止值存在差异。本综述的目的是批判性地评估用于诊断老年人肌肉减少性吞咽困难的工具。对文献进行了全面综述。对用于诊断“肌肉减少性吞咽困难”的诊断工具的研究进行了定性评估，并与 SD 的已知诊断标准和其他公认的测量方法进行了比较。从 331 篇去重研究中，共选择了 14 项研究（N=10282）。93%的研究（13/14）在日本进行。所有纳入的研究对象年龄均超过 65 岁（平均年龄 76.5 岁）。有 14 项研究（14/14）使用各种工具评估肌肉减少症，包括握力（14 项研究中的 13 项），其次是骨骼肌质量/指数（7 项研究中的 7 项）、舌压、步速和小腿围度（5 项研究中的 5 项）。最常用于评估吞咽困难和/或吞咽功能障碍的工具是食物水平摄入量表（14 项研究中的 5 项），其次是功能性口腔摄入量表（14 项研究中的 3 项）。在纳入的 14 项 SD 研究中，有 2 项使用了 100 毫升水吞咽试验。纤维光学吞咽评估、视频透视吞咽研究、EAT-10 问卷和标准化吞咽评估分别仅在 1 项 SD 研究中使用。需要进一步研究以验证 SD 诊断工具，在不同人群中建立截止值，并研究其在老年人吞咽困难和吞咽功能障碍筛查中的作用。
