Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
BMC Gastroenterol. 2023 Mar 11;23(1):69. doi: 10.1186/s12876-023-02709-3.
Although swallowing disorders can impact individuals of any age, some are unique to the elderly, and others are frequent. Some disorders, such as achalasia, are diagnosed by esophageal manometry studies, which assess lower esophageal sphincter (LES) pressure and relaxation, peristalsis in the esophageal body, and contraction wave characteristics. This research aimed to evaluate esophageal motility dysfunction in symptomatic patients and its relation to age.
Conventional esophageal manometry was performed on 385 symptomatic patients who were divided into two groups; Group A (age < 65 years old) and Group B (age ≥ 65 years). The geriatric assessment for Group B included cognitive, functional, and clinical frailty scales (CFS). Additionally, a nutritional assessment was done for all patients.
About one-third of the patients (33%) had achalasia, in which manometric results were significantly higher in Group B (43.4%) than in Group A (28.7%) (P = 0.016). The resting lower esophageal sphincter (LES) pressure, as determined by manometry examination, was significantly lower in Group A than in Group B. In contrast, complete LES relaxation percentage and normal esophageal body peristalsis were significantly higher in Group A than in Group B. Patients who exhibited evidence of achalasia in the manometric study had a significantly increased risk of established malnutrition and functional impairment.
Achalasia is a prevalent cause of dysphagia in elderly patients, placing them at risk of malnutrition and functional impairment. Thus, a multidisciplinary approach is vital when providing care for this population.
吞咽障碍可影响任何年龄段的个体，其中一些在老年人中较为独特，而另一些则较为常见。一些疾病，如贲门失弛缓症，通过食管测压研究来诊断，该研究评估下食管括约肌（LES）压力和松弛、食管体蠕动以及收缩波特征。本研究旨在评估有症状患者的食管运动功能障碍及其与年龄的关系。
对 385 名有症状的患者进行常规食管测压，将他们分为两组；A 组（年龄<65 岁）和 B 组（年龄≥65 岁）。B 组的老年评估包括认知、功能和临床虚弱量表（CFS）。此外，对所有患者进行营养评估。
约三分之一的患者（33%）患有贲门失弛缓症，其中 B 组（43.4%）的测压结果明显高于 A 组（28.7%）（P=0.016）。通过测压检查确定的静息下食管括约肌（LES）压力在 A 组明显低于 B 组。相比之下，A 组的完全 LES 松弛百分比和正常食管体蠕动明显高于 B 组。在测压研究中表现出贲门失弛缓症证据的患者有明显更高的营养不良和功能障碍风险。
贲门失弛缓症是老年患者吞咽困难的常见原因，使他们面临营养不良和功能障碍的风险。因此，当为这一人群提供护理时，多学科方法至关重要。
