阿尔茨海默病与老年性吞咽困难的老年人的口咽吞咽困难比较

The Comparison of Oropharyngeal Dysphagia in Alzheimer's Disease versus Older Adults with Presbyphagia.

作者信息

Tanrıverdi Müberra, Osmanoğlu Emre, Gelişin Özlem, Çalım Ömer Faruk, Soysal Pinar

机构信息

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Bezmialem Vakıf University, İstanbul, Türkiye.

Faculty of Medicine, Department of Otolaryngology, Bezmialem Vakıf University, İstanbul, Türkiye.

出版信息

Dysphagia. 2024 Oct 30. doi: 10.1007/s00455-024-10777-0.

Abstract

Dysphagia is defined as difficulty in swallowing, while presbyphagia is described as a change in swallowing process in healthy older adults, which is a compensable physiological impairment and synonymous with dysphagia. Aging is a well-known risk factor for Alzheimer's disease (AD), and oropharyngeal dysphagia (OD) is a common condition in AD. Our study aims to compare OD in AD patients and older adults with presbyphagia (OAwP). 65 older adults (AD = 32, mean age:76.5 ± 6; OAwP = 33, mean age:71.1 ± 4) were included. Swallowing disorders were evaluated by Flexible Endoscopic Evaluation Study, which scored by Penetration Aspiration Scale (PAS) that scores other than 1 indicate dysphagia, Murray Secretion Severity Scale (MSSS), and Eating Assessment Tool-10 (EAT-10). Neurologist determined Clinical Dementia Rating (CDR) scores of AD patients. AD and OAwP groups had OD, respectively, 96.87% vs. 81.81% by PAS, 87.5% vs. 60.60% by MSSS, and 56.25% vs. 18.18% by EAT-10. No statistical differences were observed between AD and OAwP in terms of gender, age, PAS, and MSSS values (p > 0.05). There was a significant difference in EAT-10 total scores (p = 0.000), and had OD by EAT-10 (p = 0.024). No differences were found in age, time elapsed since diagnosis, PAS, and EAT-10 scores based on CDR, but there was a difference in MSSS scores (p = 0.013). CDR in AD were associated with gender, time elapsed since diagnosis, and MSSS scores (p < 0.05). OAwP experience swallowing problems at least as much as those with AD. Evaluation of swallowing disorders after diagnosis is essential for both AD and OAwP. Early-stage management of disease with preventive treatment approaches can delay onset of symptoms.

摘要

吞咽困难被定义为吞咽困难,而老年吞咽困难被描述为健康老年人吞咽过程中的变化,这是一种可代偿的生理损伤,与吞咽困难同义。衰老是阿尔茨海默病(AD)的一个众所周知的风险因素,口咽吞咽困难(OD)是AD中的常见病症。我们的研究旨在比较AD患者和患有老年吞咽困难(OAwP)的老年人的OD情况。纳入了65名老年人(AD组 = 32名,平均年龄:76.5 ± 6岁;OAwP组 = 33名,平均年龄:71.1 ± 4岁)。通过柔性内镜评估研究评估吞咽障碍,该研究通过穿透误吸量表(PAS)评分(评分不为1表示吞咽困难)、默里分泌物严重程度量表(MSSS)和进食评估工具 - 10(EAT - 10)进行评分。神经科医生确定AD患者的临床痴呆评定量表(CDR)评分。AD组和OAwP组分别有OD,通过PAS评估分别为96.87%对81.81%,通过MSSS评估分别为87.5%对60.60%,通过EAT - 10评估分别为56.25%对18.18%。在性别、年龄、PAS和MSSS值方面,AD组和OAwP组之间未观察到统计学差异(p > 0.05)。EAT - 10总分存在显著差异(p = 0.000),且通过EAT - 10评估有OD(p = 0.024)。基于CDR,在年龄、诊断后经过的时间、PAS和EAT - 10评分方面未发现差异,但MSSS评分存在差异(p = 0.013)。AD患者的CDR与性别、诊断后经过的时间和MSSS评分相关(p < 0.05)。OAwP经历吞咽问题的程度至少与AD患者一样多。诊断后对吞咽障碍的评估对AD和OAwP都至关重要。采用预防性治疗方法对疾病进行早期管理可以延迟症状的出现。

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