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帕金森病患者与非帕金森病患者口腔状况、吞咽功能与营养风险的关系。

Relationship between oral status, swallowing function, and nutritional risk in older people with and without Parkinson's disease.

机构信息

Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil.

Hospital Universitário Onofre Lopes - HUOL - Natal (RN), Brasil.

出版信息

Codas. 2024 Aug 5;36(5):e20230311. doi: 10.1590/2317-1782/20242023311pt. eCollection 2024.

Abstract

PURPOSE

To compare oral status, swallowing function (through instrumental and SLH assessment), and nutritional risk between dysphagic individuals with and without Parkinson's disease.

METHOD

This is a cross-sectional retrospective study based on data collected from medical records. It included 54 dysphagic older adults, divided into two groups according to the diagnosis of Parkinson's disease. The study collected data on the speech-language-hearing assessment of postural control, tongue mobility and strength, maximum phonation time (MPT), and cough efficiency. Oral status was assessed using the number of teeth and the Eichner Index. The level of oral intake and pharyngeal signs of dysphagia were analyzed with four food consistencies, according to the International Dysphagia Diet Standardization Initiative classification, using fiberoptic endoscopic evaluation of swallowing, for comparison between groups. The severity of pharyngeal residues was analyzed and classified with the Yale Pharyngeal Residue Severity Rating Scale, and the nutritional risk was screened with the Malnutrition Screening Tool.

RESULTS

The group of older adults with Parkinson's disease was significantly different from the other group in that they had fewer teeth, unstable postural control, reduced tongue strength, reduced MPT, weak spontaneous coughing, pharyngeal signs, less oral intake, and nutritional risk.

CONCLUSION

Dysphagic older people with Parkinson's disease had different oral status, swallowing function, and nutritional risk from those without the diagnosis.

摘要

目的

比较有和无帕金森病的吞咽障碍患者的口腔状况、吞咽功能(通过仪器和 SLH 评估)和营养风险。

方法

这是一项基于病历数据的回顾性横断面研究。它纳入了 54 名吞咽障碍的老年患者,根据帕金森病的诊断将其分为两组。研究收集了姿势控制、舌部运动和力量、最大发音时间(MPT)和咳嗽效率的言语语言听力评估数据。口腔状况通过牙齿数量和 Eichner 指数进行评估。根据国际吞咽障碍饮食标准化倡议分类,使用纤维内镜吞咽评估对四种食物稠度进行分析,以比较组间差异,分析和分类咽残留的严重程度采用耶鲁咽残留严重程度评分量表,使用营养不良筛查工具筛查营养风险。

结果

患有帕金森病的老年患者组与其他组相比,牙齿数量较少,姿势控制不稳定,舌部力量减弱,MPT 降低,自发性咳嗽无力,有咽征象,口腔摄入减少,存在营养风险。

结论

患有帕金森病的吞咽障碍老年患者的口腔状况、吞咽功能和营养风险与无该诊断的患者不同。

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本文引用的文献

1
Tongue strength and clinical correlations in Parkinson's disease.帕金森病患者的舌部力量与临床相关性。
J Oral Rehabil. 2023 Apr;50(4):300-307. doi: 10.1111/joor.13417. Epub 2023 Jan 27.
5
Comorbid Dysphagia and Malnutrition in Elderly Hospitalized Patients.老年住院患者的吞咽困难与营养不良共病
Laryngoscope. 2021 Nov;131(11):2441-2447. doi: 10.1002/lary.29329. Epub 2021 Jan 25.

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