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Eating Difficulties among Older Adults with Dementia in Long-Term Care Facilities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910109. [PMID: 34639409 PMCID: PMC8508293 DOI: 10.3390/ijerph181910109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 01/17/2023]
Abstract
This paper reports a scoping review of the literature on eating difficulties among older adults with dementia in long-term care facilities to identify key concepts, methods of measuring outcomes, interventions, and related factors. A scoping review was performed using the bibliographic databases PubMed, CINAHL, PsycINFO, and Cochrane Library. A combination of keywords and subject headings related to eating or feeding difficulties was used. Inclusion criteria were limited to materials published in English. A total of 1070 references were retrieved, of which 39 articles were selected after applying the inclusion and exclusion criteria. Articles that met the criteria were published between 1987 and 2020. “Eating disabilities” have been defined as problems related to choosing food and/or the ability to get food to one’s mouth, chew, and swallow. Interventions for eating difficulties described in the literature include spaced retrieval training, Montessori training, and feeding skill training. Intrapersonal, interpersonal, and environmental factors related to eating difficulties were identified. This scoping review will provide direct care workers, nursing educators, and administrators with an overview of eating performance and a broad understanding of eating difficulties for older adults with dementia in long-term care facilities.
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Effect of Acupuncture on Cognitive Function of Insomnia Patients Compared with Drugs: A Protocol for Meta-analysis and Systematic Review. Behav Neurol 2021; 2021:6158275. [PMID: 34552671 PMCID: PMC8452430 DOI: 10.1155/2021/6158275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/30/2021] [Indexed: 11/17/2022] Open
Abstract
Insomnia, one of the most common sleep disorders, is thought to have an adverse effect on cognitive function. At the same time, people with cognitive dysfunction are more prone to insomnia. At present, pharmacotherapy is the main treatment for insomnia, but there are some shortcomings such as poor long-term efficacy and potential dependence. There is some evidence that acupuncture has some advantages in alleviating insomnia and improving cognitive function. This study is aimed at investigating the effects of acupuncture and drugs on cognitive function in patients with insomnia and evaluating the efficacy and safety of these two interventions, providing strong evidence for clinical decision-making. The study will retrieve eight major databases: China National Knowledge Infrastructure, Wanfang Database, VIP Database for Chinese Technical Periodicals, SinoMed, PubMed, Web of Science, Embase, and Cochrane Library. Dissertations, conference papers, and ongoing experiments will also be retrieved for supplement. Literature screening and data extraction will be completed by two authors independently (JJ and X-QW). If there were any disagreements, they would be discussed or referred to a third person for adjudication (W-ZW). Authors will use Cochrane risk of bias tool to assess the included studies. The Review Manager Statistical (RevMan) software is used to conduct the statistical process of meta-analysis, and funnel plot is used to evaluate reporting biases. The Grading of Recommendations Assessment Development and Evaluation (GRADE) Profiler can be used to be aware of the quality of evidence.
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Riera SA, Marin S, Serra-Prat M, Tomsen N, Arreola V, Ortega O, Walshe M, Clavé P. A Systematic and a Scoping Review on the Psychometrics and Clinical Utility of the Volume-Viscosity Swallow Test (V-VST) in the Clinical Screening and Assessment of Oropharyngeal Dysphagia. Foods 2021; 10:1900. [PMID: 34441677 PMCID: PMC8391460 DOI: 10.3390/foods10081900] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 02/02/2023] Open
Abstract
(1) Background: The volume-viscosity swallow test (V-VST) is a clinical tool for screening and diagnosis of oropharyngeal dysphagia (OD). Our aims were to examine the clinical utility of the V-VST against videofluoroscopy (VFS) or fiberoptic endoscopic evaluation of swallow (FEES) and to map the V-VST usage with patients at risk of OD across the years since it was described for the first time, carrying a systematic and a scoping review. (2) Methods: We performed both a systematic review (SR) including studies that look at the diagnostic test accuracy, and a scoping review (ScR) with articles published from September 2008 to May 2020. Searches were done in different databases, including PubMed and EMBASE from September 2008 until May 2020, and no language restrictions were applied. A meta-analysis was done in the SR to assess the psychometric properties of the V-VST. Quality of studies was assessed by Dutch Cochrane, QUADAS, GRADE (SR), and STROBE (ScR) criteria. The SR protocol was registered on PROSPERO (registration: CRD42020136252). (3) Results: For the diagnostic accuracy SR: four studies were included. V-VST had a diagnostic sensitivity for OD of 93.17%, 81.39% specificity, and an inter-rater reliability Kappa = 0.77. Likelihood ratios (LHR) for OD were 0.08 (LHR-) and 5.01 (LHR+), and the diagnostic odds ratio for OD was 51.18. Quality of studies in SR was graded as high with low risk of bias. In the ScR: 34 studies were retrieved. They indicated that V-VST has been used internationally to assess OD's prevalence and complications. (4) Conclusions: The V-VST has strong psychometric properties and valid endpoints for OD in different phenotypes of patients. Our results support its utility in the screening and clinical diagnosis and management of OD.
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Affiliation(s)
- Stephanie A. Riera
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Catalunya, Spain; (S.A.R.); (S.M.); (N.T.); (V.A.); (O.O.)
- Department of Surgery and Morphological Sciences, University Autonomous of Barcelona, 08193 Cerdanyola del Vallès, Catalunya, Spain
| | - Sergio Marin
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Catalunya, Spain; (S.A.R.); (S.M.); (N.T.); (V.A.); (O.O.)
- Department of Pharmacy, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Catalunya, Spain
| | - Mateu Serra-Prat
- Research Unit, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Catalunya, Spain;
| | - Noemí Tomsen
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Catalunya, Spain; (S.A.R.); (S.M.); (N.T.); (V.A.); (O.O.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 08304 Mataró, Catalunya, Spain
| | - Viridiana Arreola
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Catalunya, Spain; (S.A.R.); (S.M.); (N.T.); (V.A.); (O.O.)
| | - Omar Ortega
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Catalunya, Spain; (S.A.R.); (S.M.); (N.T.); (V.A.); (O.O.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 08304 Mataró, Catalunya, Spain
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College, 8PVW G5 Dublin, Ireland;
| | - Pere Clavé
- Gastrointestinal Motility Laboratory, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, Catalunya, Spain; (S.A.R.); (S.M.); (N.T.); (V.A.); (O.O.)
- Department of Surgery and Morphological Sciences, University Autonomous of Barcelona, 08193 Cerdanyola del Vallès, Catalunya, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 08304 Mataró, Catalunya, Spain
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Wu XS, Miles A, Braakhuis AJ. Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review. Healthcare (Basel) 2021; 9:624. [PMID: 34073835 PMCID: PMC8225071 DOI: 10.3390/healthcare9060624] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/24/2022] Open
Abstract
While the association between dysphagia and malnutrition is well established, there is a lack of clarity regarding the nutritional status and mealtime satisfaction of those consuming texture-modified diets (TMDs). This systematic review summarises and critically appraises the nutritional status and mealtime satisfaction of adults consuming TMDs. A systematic database search following PICO criteria was conducted using Cochrane Central (via Ovid), MEDLINE, CINAHL, EMBASE and Scopus. Nutritional status, mealtime satisfaction and costs were identified as primary outcomes. Eligible studies were grouped according to outcome measurement. In total, 26 studies met the inclusion criteria. Twenty studies evaluated the nutritional status by weight change or using malnutrition screening tools and found the consumption of TMDs correlated with weight loss or malnutrition. Nine studies evaluated mealtime satisfaction, with two reporting poor satisfaction for people on thickened fluids (TFs). Nutrition intervention through adjusting texture and consistency and nutrition enrichment showed positive effects on weight and mealtime satisfaction. The majority of the studies were rated as 'neutral' quality due to the limited number of experiments. TMD consumers had compromised nutritional status and poor mealtime satisfaction. More research input is required to identify promising strategies for improving the nutritional status and mealtime satisfaction of this population. Food services need to consider texture, consistency and fortification in designing menus for people on TMDs to avoid weight loss and malnutrition, and to enhance mealtime enjoyment.
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Affiliation(s)
- Xiaojing Sharon Wu
- Faculty of Medical and Health Sciences, Discipline of Nutrition, The University of Auckland, Auckland 1010, New Zealand;
| | - Anna Miles
- Faculty of Science, School of Psychology, Speech Science, The University of Auckland, Auckland 1010, New Zealand;
| | - Andrea J. Braakhuis
- Faculty of Medical and Health Sciences, Discipline of Nutrition, The University of Auckland, Auckland 1010, New Zealand;
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Rodd BG, Tas AA, Taylor KDA. Dysphagia, texture modification, the elderly and micronutrient deficiency: a review. Crit Rev Food Sci Nutr 2021; 62:7354-7369. [PMID: 33905267 DOI: 10.1080/10408398.2021.1913571] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Dysphagia is an underlying symptom of many health issues affecting a person's ability to swallow. Being unable to swallow correctly may limit food intake and subsequently micronutrient status. The elderly may be the most at risk group of suffering dysphagia as well as most likely to be deficient in micronutrients. The use of texture-modified meals is a common approach to increasing dysphagia sufferer's food intake. The modification of food may affect the micronutrient content and currently there is a limited number of studies focusing on micronutrient content of texture-modified meals. This review considers the prevalence of dysphagia within the elderly UK community whilst assessing selected micronutrients. Vitamin B12, C, D, folate, zinc and iron, which are suggested to be most likely deficient in the general elderly UK population, were reviewed. Each micronutrient is considered in terms of prevalence of deficiency, metabolic function, food source and processing stability to provide an overview with respect to elderly dysphagia sufferers.
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Affiliation(s)
- B G Rodd
- National Centre for Food Manufacturing, College of Science, University of Lincoln, Lincoln, UK
| | - A A Tas
- National Centre for Food Manufacturing, College of Science, University of Lincoln, Lincoln, UK
| | - K D A Taylor
- National Centre for Food Manufacturing, College of Science, University of Lincoln, Lincoln, UK
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Xiao D, Peng C, Chen H, Xiao H, Li H. Efficacy of Tongguan Liyan Decoction on pharyngeal cancer-induced dysphagia. ALL LIFE 2021. [DOI: 10.1080/26895293.2021.1891144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Dongjie Xiao
- Department of Geriatrics, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, People’s Republic of China
| | - Can Peng
- Department of Geriatrics, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, People’s Republic of China
| | - Haiyan Chen
- Department of Geriatrics, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, People’s Republic of China
| | - Haiyan Xiao
- Department of Geriatrics, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, People’s Republic of China
| | - Huahua Li
- Department of Geriatrics, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, People’s Republic of China
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Fernández-Ruiz VE, Paredes-Ibáñez R, Armero-Barranco D, Sánchez-Romera JF, Ferrer M. Analysis of Quality of Life and Nutritional Status in Elderly Patients with Dysphagia in Order to Prevent Hospital Admissions in a COVID-19 Pandemic. Life (Basel) 2020; 11:22. [PMID: 33396486 PMCID: PMC7824070 DOI: 10.3390/life11010022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 12/28/2022] Open
Abstract
(1) Background: Oropharyngeal dysphagia (OD) is currently recognized as one of the geriatric syndromes due to its high frequency in older people and its associated complications, which have a direct impact on quality of life. The main objective is to determine the effectiveness of telehealth consultation for the re-evaluation of nutritional status and quality of life assessment in older people diagnosed with OD associated with active use of thickeners to prevent hospital admissions in a COVID-19 pandemic. (2) Methods: an observational, descriptive, and longitudinal study that included a sample of 33 subjects with age equal or superior to 65 years diagnosed with OD with conserved cognitive capacity. The nutritional status was evaluated through the Mini-Nutritional Assessment (MNA) questionnaire and biochemical parameters and, the quality of life was determined through the Swallowing Quality of Life (SWAL-QOL) questionnaire. (3) Results: Thirty-three older patients with OD were recruited (54.5% women), with a mean age of 83.5 ± 7.6 years. The main cause of OD in the study population was neurodegenerative disease (51.5%), followed by cerebrovascular disease (33.3%), and other causes (15.2%). Sixty point six percent of patients were found to be at risk of malnutrition. The MNA score was significantly correlated to albumin (r: 0.600, p < 0.001) and total proteins (r: 0.435, p = 0.015), but not to total cholesterol (r: -0.116, p = 0.534) or lymphocytes (r: -0.056, p = 0.758). The mean total score of the SWAL-QOL was 75.1 ± 16.4 points. (4) Conclusions: the quality of life of the subjects related to the use of a thickener is good. Although the body mass index (BMI) and average biochemical, nutritional parameters of the subjects are within the range of normality, the MNA has detected a high percentage of subjects with the risk of malnutrition, which suggests the need for continuous re-evaluation in these patients, demonstrating the viability of the telematic route in this research.
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Affiliation(s)
- Virginia E. Fernández-Ruiz
- Department of Endocrinology and Nutrition, Virgen de la Arrixaca University Clinic Hospital, 30120 Murcia, Spain; (V.E.F.-R.); (M.F.)
- Faculty of Nursing, Calle Campus Universitario, University of Murcia, 11, 30100 Murcia, Spain;
| | - Rocío Paredes-Ibáñez
- Community and Family Nursing Specialist, Calle Campus Universitario, University of Murcia, 11, 30100 Murcia, Spain
| | - David Armero-Barranco
- Faculty of Nursing, Calle Campus Universitario, University of Murcia, 11, 30100 Murcia, Spain;
| | - Juan Francisco Sánchez-Romera
- Department of Human Anatomy and Psychobiology, Calle Campus Universitario, University of Murcia, 11, 30100 Murcia, Spain;
| | - Mercedes Ferrer
- Department of Endocrinology and Nutrition, Virgen de la Arrixaca University Clinic Hospital, 30120 Murcia, Spain; (V.E.F.-R.); (M.F.)
- Endocrinology and Nutrition Department, Calle Campus Universitario, University of Murcia, 11, 30100 Murcia, Spain
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Wu XS, Miles A, Braakhuis A. Nutritional Intake and Meal Composition of Patients Consuming Texture Modified Diets and Thickened Fluids: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2020; 8:healthcare8040579. [PMID: 33371326 PMCID: PMC7767351 DOI: 10.3390/healthcare8040579] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/10/2020] [Accepted: 12/17/2020] [Indexed: 12/26/2022] Open
Abstract
Texture-modified diets (TMDs) play an important role in ensuring safety for those with dysphagia but come with risks to nutrition and quality of life. The use of TMDs has been addressed with the increasing prevalence of dysphagia in previous decades. However, there is limited literature that investigates the nutrition perspectives of TMD consumers. This review summarises the nutrition outcomes of adults consuming TMDs and thickened fluids (TFs) and identifies the limitations of TMD and TF productions. A systematic database search following PICO criteria was conducted using Cochrane Central (via Ovid), MEDLINE, CINAHL, EMBASE, and Scopus databases. Nutrition intake, meal consumption, adequacy, and meal composition were identified as relevant outcomes. 35 studies were included for analysis. Consumption of TMDs demonstrated a poorer intake compared to regular diets, in particular significant in energy and calcium. Meta-analysis of mean differences showed favourable effects of shaped TMDs on both energy (−273.8 kJ/d; 95%CI: −419.1 to −128.6, p = 0.0002) and protein (−12.4 g/d; 95%CI: −17.9 to −6.8, p < 0.0001) intake compared to traditional cook-fresh TMDs. Nutrition intake was compromised in TMD consumers. Optimisation of nutrition intake was achievable through enrichment and adjusting meal texture and consistency. However, the heterogeneity of studies and the missing verification of the consistencies lead to difficulty in drawing conclusions regarding particular texture or intervention.
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Affiliation(s)
- Xiaojing Sharon Wu
- Faculty of Medical and Health Sciences, Discipline of Nutrition, The University of Auckland, Auckland 1010, New Zealand;
- Correspondence: ; Tel.: +64-210-859-9592
| | - Anna Miles
- Faculty of Science, School of Psychology, Speech Science, The University of Auckland, Auckland 1010, New Zealand;
| | - Andrea Braakhuis
- Faculty of Medical and Health Sciences, Discipline of Nutrition, The University of Auckland, Auckland 1010, New Zealand;
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Haresaku S, Nakashima F, Hara Y, Kuroki M, Aoki H, Kubota K, Naito T. Associations of Oral Health-Related Quality of Life with age, oral status, and oral function among psychiatric inpatients in Japan: a cross-sectional study. BMC Oral Health 2020; 20:361. [PMID: 33317511 PMCID: PMC7737280 DOI: 10.1186/s12903-020-01355-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND As the general population of Japan ages, the population of hospitalized psychiatric patients is also ageing. The purpose of this study was to investigate the associations of oral health-related quality of life (OHRQoL) with age and oral health, including oral and swallowing function, among psychiatric inpatients. METHODS The subjects included 165 psychiatric inpatients in psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and the screening of dysphagia. A score ≥ 3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. The inpatients with acute psychiatric symptoms, moderate and severe dementia, and cognitive impairment that affected their ability to communicate and relate their feelings were excluded. A chi-squared test, the Mann-Whitney U test, and linear regression analysis were used for the analysis. The data were analysed at the 5% significance level. RESULTS A total of 100 (64.5%) psychiatric inpatients (mean age, 67.3 [SD, 14.5] years, 49% males, and 51% females) participated in this study. The means ± SDs for the decayed missing filled teeth (DMFT) index and GOHAI score were 20.6 ± 6 and 49.7 ± 7.9, respectively. The GOHAI score in the older age group (≥ 65 years) was significantly lower than that in the younger age group (< 65 years). The mean ODK scores were less than 3 times/s for all syllables. The percentage of the participants with suspected dysphagia was 45.0%. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (β = - 0.725, 95% CI - 0.97, - 0.64). CONCLUSIONS In hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.
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Affiliation(s)
- Satoru Haresaku
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan.
| | - Fuyuko Nakashima
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Yayoi Hara
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Madoka Kuroki
- Department of Dental Hygiene, Fukuoka College of Health Sciences, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Hisae Aoki
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Keiko Kubota
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
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Is IDDSI an Evidence-Based Framework? A Relevant Question for the Frail Older Population. Geriatrics (Basel) 2020; 5:geriatrics5040082. [PMID: 33096747 PMCID: PMC7709687 DOI: 10.3390/geriatrics5040082] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023] Open
Abstract
To delay impacts of aging, optimal nutritional status is essential. Several factors can reduce food intake, such as isolation, income, and cognitive/physical decline. Additionally, chewing and swallowing difficulties, or dysphagia, often disrupt the ability to consume life-long favorite dishes. Food and liquids could require modification of texture or consistency to ensure a comfortable or safe swallow. The food industry, foodservices facilities, and caregivers need quality control benchmarks to provide adequate nourishment and meet these new feeding challenges. The International Dysphagia Diet Standardisation Initiative (IDDSI) is proposing the IDDSI framework and testing methods to describe food used in nutritional care plans to circumvent dysphagia and improve communication among caregivers. This systematic review assesses the validity and reliability of the IDDSI testing methods using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). Two publications presented content validity whereas 19 publications looked at construct validity or reliability for the IDDSI testing methods. One study was conducted in older adults presenting dysphagia. This review concludes that there is insufficient evidence to recommend the IDDSI testing methods. Further research, conducted with robust methodological design and reporting, is needed to develop and assess nutritious adapted food for frail older populations.
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Hossain MZ, Ando H, Unno S, Kitagawa J. Targeting Chemosensory Ion Channels in Peripheral Swallowing-Related Regions for the Management of Oropharyngeal Dysphagia. Int J Mol Sci 2020; 21:E6214. [PMID: 32867366 PMCID: PMC7503421 DOI: 10.3390/ijms21176214] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 12/22/2022] Open
Abstract
Oropharyngeal dysphagia, or difficulty in swallowing, is a major health problem that can lead to serious complications, such as pulmonary aspiration, malnutrition, dehydration, and pneumonia. The current clinical management of oropharyngeal dysphagia mainly focuses on compensatory strategies and swallowing exercises/maneuvers; however, studies have suggested their limited effectiveness for recovering swallowing physiology and for promoting neuroplasticity in swallowing-related neuronal networks. Several new and innovative strategies based on neurostimulation in peripheral and cortical swallowing-related regions have been investigated, and appear promising for the management of oropharyngeal dysphagia. The peripheral chemical neurostimulation strategy is one of the innovative strategies, and targets chemosensory ion channels expressed in peripheral swallowing-related regions. A considerable number of animal and human studies, including randomized clinical trials in patients with oropharyngeal dysphagia, have reported improvements in the efficacy, safety, and physiology of swallowing using this strategy. There is also evidence that neuroplasticity is promoted in swallowing-related neuronal networks with this strategy. The targeting of chemosensory ion channels in peripheral swallowing-related regions may therefore be a promising pharmacological treatment strategy for the management of oropharyngeal dysphagia. In this review, we focus on this strategy, including its possible neurophysiological and molecular mechanisms.
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Affiliation(s)
- Mohammad Zakir Hossain
- Department of Oral Physiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara Hirooka, Shiojiri, Nagano 399-0781, Japan;
| | - Hiroshi Ando
- Department of Biology, School of Dentistry, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano 399-0781, Japan;
| | - Shumpei Unno
- Department of Oral Physiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara Hirooka, Shiojiri, Nagano 399-0781, Japan;
| | - Junichi Kitagawa
- Department of Oral Physiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara Hirooka, Shiojiri, Nagano 399-0781, Japan;
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