Kakehi Shingo, Isono Eri, Wakabayashi Hidetaka, Shioya Moeka, Ninomiya Junki, Aoyama Yohei, Murai Ryoko, Sato Yuka, Takemura Ryohei, Mori Amami, Masumura Kei, Suzuki Bunta
Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Ann Rehabil Med. 2023 Oct;47(5):337-347. doi: 10.5535/arm.23101. Epub 2023 Oct 31.
Sarcopenic dysphagia is characterized by weakness of swallowing-related muscles associated with whole-body sarcopenia. As the number of patients with sarcopenia increases with the aging of the world, the number of patients with sarcopenic dysphagia is also increasing. The prevalence of sarcopenic dysphagia is high in the institutionalized older people and in patients hospitalized for pneumonia with dysphagia in acute care hospitals. Prevention, early detection and intervention of sarcopenic dysphagia with rehabilitation nutrition are essential. The diagnosis of sarcopenic dysphagia is based on skeletal and swallowing muscle strength and muscle mass. A reliable and validated diagnostic algorithm for sarcopenic dysphagia is used. Sarcopenic dysphagia is associated with malnutrition, which leads to mortality and Activities of Daily Living (ADL) decline. The rehabilitation nutrition approach improves swallowing function, nutrition status, and ADL. A combination of aggressive nutrition therapy to improve nutrition status, dysphagia rehabilitation, physical therapy, and other interventions can be effective for sarcopenic dysphagia. The rehabilitation nutrition care process is used to assess and problem solve the patient's pathology, sarcopenia, and nutrition status. The simplified rehabilitation nutrition care process consists of a nutrition cycle and a rehabilitation cycle, each with five steps: assessment, diagnosis, goal setting, intervention, and monitoring. Nutrition professionals and teams implement the nutrition cycle. Rehabilitation professionals and teams implement the rehabilitation cycle. Both cycles should be done simultaneously. The nutrition diagnosis of undernutrition, overnutrition/obesity, sarcopenia, and goal setting of rehabilitation and body weight are implemented collaboratively.
肌少症性吞咽困难的特征是与全身肌少症相关的吞咽相关肌肉无力。随着世界人口老龄化,肌少症患者数量增加,肌少症性吞咽困难患者数量也在增加。在机构养老的老年人以及急性护理医院中因肺炎伴吞咽困难住院的患者中,肌少症性吞咽困难的患病率很高。通过康复营养对肌少症性吞咽困难进行预防、早期检测和干预至关重要。肌少症性吞咽困难的诊断基于骨骼肌和吞咽肌力量以及肌肉质量。使用一种可靠且经过验证的肌少症性吞咽困难诊断算法。肌少症性吞咽困难与营养不良相关,营养不良会导致死亡率上升和日常生活活动能力(ADL)下降。康复营养方法可改善吞咽功能、营养状况和ADL。积极的营养治疗以改善营养状况、吞咽困难康复、物理治疗和其他干预措施相结合,对肌少症性吞咽困难可能有效。康复营养护理过程用于评估患者的病理状况、肌少症和营养状况并解决相关问题。简化的康复营养护理过程包括一个营养周期和一个康复周期,每个周期都有五个步骤:评估、诊断、目标设定、干预和监测。营养专业人员和团队实施营养周期。康复专业人员和团队实施康复周期。两个周期应同时进行。营养不良、营养过剩/肥胖、肌少症的营养诊断以及康复和体重的目标设定需协同实施。
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