School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan.
Eur Geriatr Med. 2024 Jun;15(3):777-785. doi: 10.1007/s41999-024-00984-1. Epub 2024 May 13.
To investigate whether two factors, malnutrition and cachexia, affect swallowing function, activities of daily living (ADL), and death in sarcopenic dysphagia.
Of 467 patients enrolled in the Japanese Sarcopenic Dysphagia Database, 271 met the study eligibility criteria in a retrospective cohort study. Patients were divided into four groups based on whether they had cachexia according to the Asian Working Group for Cachexia (AWGC) criteria and malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Multivariate analyses were performed to investigate the differences in changes in the Food Intake LEVEL Scale (FILS) and Barthel Index (BI) and death after follow-up between the malnutrition and cachexia group and the other groups.
The mean age was 83.7 ± 8.3 years, 119 (44%) were men and 152 (56%) were women. The median FILS at baseline was 7 and the median BI was 25. A total of 120 (44%) had malnutrition only, 54 (20%) had neither cachexia nor malnutrition, 12 (4%) had cachexia only, and 85 (31%) had both cachexia and malnutrition. Multivariate analyses showed no significant difference between the change in BI (P = 0.688) and the change in FILS (P = 0.928) between the malnutrition and cachexia group and the other groups; however, death increased significantly (P = 0.010).
Some patients diagnosed with cachexia were not malnourished, although many patients with cachexia were malnourished. While patients with both cachexia and malnutrition did not show significant improvement in ADL and swallowing function compared with patients without both conditions, the number of deaths increased significantly.
探讨营养不良和恶病质这两个因素是否会影响肌少症吞咽障碍患者的吞咽功能、日常生活活动能力（ADL）和死亡情况。
在日本肌少症吞咽障碍数据库中纳入的 467 例患者中，有 271 例符合回顾性队列研究的入选标准。根据亚洲恶病质工作组（AWGC）标准确定患者是否存在恶病质，根据全球营养不良倡议（GLIM）标准确定患者是否存在营养不良，将患者分为 4 组。通过多变量分析比较营养不良和恶病质组与其他组之间随访后 FILS 和 BI 的变化差异以及死亡情况。
患者的平均年龄为 83.7±8.3 岁，其中 119 例（44%）为男性，152 例（56%）为女性。基线时 FILS 的中位数为 7，BI 的中位数为 25。共有 120 例（44%）仅有营养不良，54 例（20%）既无恶病质也无营养不良，12 例（4%）仅有恶病质，85 例（31%）同时存在恶病质和营养不良。多变量分析显示，BI 的变化（P=0.688）和 FILS 的变化（P=0.928）在营养不良和恶病质组与其他组之间无显著差异；然而，死亡率显著增加（P=0.010）。
一些被诊断为恶病质的患者并没有营养不良，尽管许多恶病质患者存在营养不良。虽然与无两者共存的患者相比，同时存在恶病质和营养不良的患者的 ADL 和吞咽功能没有显著改善，但死亡人数显著增加。
