Chan Charis Tsz Wun, Wu Tsz Yin, Cheng Ivy
Academic Unit of Human Communication, Learning and Development, Faculty of Education, The University of Hong Kong, Room 766, 7/F, Meng Wah Complex, Hong Kong, China.
Centre for Gastrointestinal Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Eur Geriatr Med. 2024 Dec;15(6):1573-1585. doi: 10.1007/s41999-024-01107-6. Epub 2024 Nov 29.
Dysphagia in persons living with dementia (PLWD) is raising concern due to the absence of swallowing treatments specific to this population. Dysphagia can result in detrimental effects, such as malnutrition, dehydration, and aspiration pneumonia. This systematic review aimed to evaluate the existing literature on dysphagia management of PLWD and reveal their limitations to facilitate clinical practitioners in decision-making.
Five electronic databases were searched systematically from the date of inception to January 2024 by two independent reviewers. Eligible studies investigated any treatments with outcome measurements evaluating swallowing function. Qualitative analyses were performed.
A total of 10 studies, involving 1360 participants, were included in the systematic review. They were analyzed qualitatively and evaluated for quality. Studies included were observational (n = 5) with prospective or retrospective designs, and randomized controlled trials (n = 5). Compensatory, rehabilitative, stimulation, and pharmacological treatments were addressed.
There is currently limited evidence available revealing the efficacy of dysphagia treatments for PLWD. Based on the current evidence, no definitive conclusions can be drawn on which treatments are more effective for this population. In the future, more randomized controlled trials with large sample sizes investigating the long-term effects of treatments are warranted.
由于缺乏针对痴呆症患者（PLWD）的吞咽治疗方法，该群体的吞咽困难问题日益受到关注。吞咽困难会导致营养不良、脱水和吸入性肺炎等不良后果。本系统评价旨在评估现有关于PLWD吞咽困难管理的文献，并揭示其局限性，以帮助临床医生进行决策。
两名独立 reviewers 从数据库创建之日起至2024年1月对五个电子数据库进行了系统检索。符合条件的研究调查了任何以评估吞咽功能的结果测量为指标的治疗方法。进行了定性分析。
本系统评价共纳入10项研究，涉及1360名参与者。对这些研究进行了定性分析和质量评估。纳入的研究包括观察性研究（n = 5），设计为前瞻性或回顾性，以及随机对照试验（n = 5）。涉及了代偿性、康复性、刺激性和药物治疗。
目前关于PLWD吞咽困难治疗效果的证据有限。基于现有证据，无法就哪些治疗方法对该群体更有效得出明确结论。未来，需要更多大样本量的随机对照试验来研究治疗的长期效果。
