Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10048, Taiwan.
Department of Physical Medicine and Rehabilitation, Far Eastern Memorial Hospital, New Taipei 22000, Taiwan.
Nutrients. 2021 Nov 12;13(11):4043. doi: 10.3390/nu13114043.
Sarcopenia, defined as a decline in muscle mass and function related to aging, affects both limb and swallowing-related muscles. Sarcopenic dysphagia is characterized by decreased swallowing function; therefore, early detection of subclinical dysphagia and subsequent intervention appear to be crucial in the elderly. Numerous tools have been employed to measure the function, strength, and mass of swallowing-related muscles in sarcopenic elderly. The swallowing function can be evaluated by questionnaires like Eating Assessment Tool, Functional Oral Intake Scale, and Food Intake Level Scale, and tests such as the modified water swallowing test and videofluoroscopic swallowing study. Surface electromyography and high-resolution manometry can be applied for quantifying swallowing-related muscle strength. Modalities such as ultrasonography and magnetic resonance imaging are capable of estimating the swallowing muscle mass. In patients with sarcopenic dysphagia, a thorough assessment should be given followed by an integrated intervention combining swallowing muscle strengthening, nutrition support, food texture modification, physical, and occupational therapies. This article aimed to comprehensively summarize the diagnostic criteria/tools as well as their associations/performance in sarcopenic dysphagia. The intervention strategy will also be narrated in this review.
肌肉减少症定义为与年龄相关的肌肉质量和功能下降,影响四肢和与吞咽相关的肌肉。肌少性吞咽困难的特征是吞咽功能下降;因此,早期发现亚临床吞咽困难并随后进行干预在老年人中似乎至关重要。已经使用了许多工具来测量与吞咽相关的肌肉的功能、力量和质量。吞咽功能可以通过问卷调查,如饮食评估工具、功能性口腔摄入量表和食物摄入水平量表,以及改良饮水吞咽试验和视频荧光透视吞咽研究等测试来评估。表面肌电图和高分辨率测压法可用于量化与吞咽相关的肌肉力量。超声和磁共振成像等方式可用于估计吞咽肌肉质量。对于肌少性吞咽困难患者,应进行全面评估,然后结合吞咽肌肉强化、营养支持、食物质地改良、物理和职业治疗等综合干预措施。本文旨在全面总结肌少性吞咽困难的诊断标准/工具及其相关性/表现。本综述还将叙述干预策略。