Institut du Vieillissement, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France.
Centre de Recherche Clinique Vieillissement, Cerveau, Fragilité, Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, Auvergne-Rhône-Alpes, France.
BMJ Open. 2024 Apr 19;14(4):e081333. doi: 10.1136/bmjopen-2023-081333.
Dysphagia, particularly sarcopenic dysphagia, is frequent in frail older patients. Sarcopenic dysphagia is a swallowing disorder caused by sarcopenia, corresponding to a loss of muscle mass and strength. It frequently leads to inhalation and to the decrease of food intake, leading the patient to enter a vicious circle of chronic malnutrition and frailty. The awareness of the major health impacts of sarcopenic dysphagia is recent, explaining a low rate of screening in the population at risk. In this context, methods of prevention, evaluation and intervention of sarcopenic dysphagia adapted to the most at-risk population are necessary.
The DYSPHAGING (dysphagia & aging) pilot study is a prospective, multicentre, non-comparative study aiming to estimate the feasibility of an intervention on allied health professionals using the DYSPHAGING educational sheet designed to implement a two-step procedure 'screen-prevent' to mitigate swallowing disorders related to sarcopenic dysphagia. After obtaining oral consent, patients are screened using Eating Assessment Tool-10 Score. In case of a score≥2, procedures including positional manoeuvres during mealtimes, food and texture adaptation should be implemented. The primary endpoint of the study is the feasibility of this two-step procedure (screening-prevention measures) in the first 3 days after patient's consent.The study will include 102 patients, with an expected 10% rate of non-analysable patients. Participants will be recruited from acute geriatric wards, rehabilitation centres and long-term care units, with the hypothesis to reach a feasibility rate of 50% and reject a rate lower than 35%.
The study protocol was approved according to French legislation (CPP Ile-de-France VII) on 15 February 2023. The results of the primary and secondary objectives will be published in peer-reviewed journals.
NCT05734586.
衰弱老年人常发生吞咽困难，尤其是肌少症性吞咽困难。肌少症性吞咽困难是一种由肌肉减少症引起的吞咽障碍，表现为肌肉质量和力量下降。它常导致吸入，减少食物摄入，使患者陷入慢性营养不良和虚弱的恶性循环。肌少症性吞咽困难对健康的重大影响最近才被认识到，这解释了高危人群筛查率低的原因。在这种情况下，需要针对高危人群制定预防、评估和干预肌少症性吞咽困难的方法。
DYSPHAGING（吞咽困难与衰老）试点研究是一项前瞻性、多中心、非对照研究，旨在评估使用 DYSPHAGING 教育表对医疗保健专业人员进行干预的可行性，该教育表旨在实施两步程序“筛查-预防”，以减轻与肌少症性吞咽困难相关的吞咽障碍。在获得口头同意后，患者使用 Eating Assessment Tool-10 评分进行筛查。如果评分≥2，应实施体位管理、饮食和质地调整等措施。该研究的主要终点是在患者同意后的头 3 天内，该两步程序（筛查-预防措施）的可行性。该研究将纳入 102 例患者，预计有 10%的患者无法进行分析。参与者将从急性老年病房、康复中心和长期护理机构招募，假设达到 50%的可行性率，并拒绝低于 35%的可行性率。
该研究方案于 2023 年 2 月 15 日根据法国立法（法兰西岛七区 CPP）获得批准。主要和次要目标的结果将在同行评议期刊上发表。
NCT05734586。
