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Agnes CS, Nayak S, Devadas U. Prevalence of oropharyngeal dysphagia symptoms in community-dwelling older adults: A community survey. Indian J Gastroenterol 2024; 43:616-627. [PMID: 38105373 DOI: 10.1007/s12664-023-01476-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/23/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Dysphagia is a common clinical condition in older adults with significant implications for health and quality of life (QOL). However, its prevalence and associated factors in the Indian community-dwelling older adults remain understudied. The present study aims at identifying the prevalence of oropharyngeal dysphagia symptoms in Indian community-dwelling older adults and identifying the age-related comorbid variables associated with an increased risk of oropharyngeal dysphagia in this population. METHODS Total 384 community-dwelling older adults (60 years of age or older) who were independent in performing daily activities were included in the present study. The Malayalam version of the Eating Assessment Tool-10 (EAT-10) questionnaire was used to assess individuals at risk for dysphagia. Additionally, they also completed a self-report questionnaire addressing age-related comorbid variables associated with an increased risk of oropharyngeal dysphagia. RESULT Using the Malayalam version of the EAT-10, the present study identified the prevalence of oropharyngeal dysphagia symptoms in 9.9% of community-dwelling older adults. Among the EAT-10 symptoms, cough while/after swallowing, difficulty swallowing solids and difficulty swallowing liquids were the most prevalent symptoms reported by participants. Increase in age and age-related comorbidities such as tooth loss, history of heart failure and digestive diseases were found to be significantly associated with the reporting of risk for dysphagia symptoms. CONCLUSION As dysphagia symptoms significantly impact the social, psychological and QOL of community-dwelling older adults, it is important to develop awareness about these symptoms among older adults, caretakers and physicians. Early detection and appropriate management of community-dwelling older adults at risk for dysphagia can contribute to better health outcomes and improved QOL.
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Affiliation(s)
- C S Agnes
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576 104, India
| | - Srikanth Nayak
- Department of Audiology and Speech-Language Pathology, Yenepoya Medical College, Yenepoya University (Deemed to Be University), Mangalore, 575 018, India
| | - Usha Devadas
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576 104, India.
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Nakagawa S, Miura K, Arai E, Taira K, Watanabe Y, Shirobe M, Motokawa K, Ohara Y, Iwasaki M, Hirano H, Ono T, Adachi A, Watanabe T, Yamazaki Y. Oral frailty, appetite and dietary variety in late-stage older adults: A cross-sectional study (the STudy of lAte-stage oldeR adulTs in Tottori; START Tottori). Geriatr Gerontol Int 2024; 24:626-633. [PMID: 38714504 DOI: 10.1111/ggi.14892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/19/2024] [Accepted: 04/23/2024] [Indexed: 05/10/2024]
Abstract
AIM Efforts to combat frailty and preserve good health in older adults have highlighted oral frailty as an early indicator of overall frailty. Individuals showing oral frailty are at an elevated risk of insufficient nutritional intake compared with those without oral frailty; however, underlying mechanisms remain poorly explored. In this cross-sectional study, we aimed to examine the link between oral frailty and undernutrition, especially regarding poor appetite and low dietary diversity. METHODS The analysis included 2727 late-stage older adults (mean age 79.9 ± 4.3 years) who underwent dental checkups in a prefecture in Japan from 2016 to 2020. The examination involved a questionnaire survey (covering basic information, frailty screening index, appetite index: Simplified Nutritional Appetite Questionnaire; and dietary variety: Dietary Variety Score) and a measurement survey (including intraoral confirmation, oral diadochokinesis and masticatory efficiency test). Individuals with three or more indications of poor oral function, identified through oral function assessment, were defined as showing oral frailty. Binomial logistic regression and path analyses examined associations among oral frailty, Simplified Nutritional Appetite Questionnaire and Dietary Variety Score. RESULTS Among those analyzed, 1208 (44.3%) participants were categorized into the oral frailty group. Binomial logistic regression analysis showed that Simplified Nutritional Appetite Questionnaire (odds ratio for oral frailty per 1-point increase 0.88, 95% confidence interval 0.84-0.93) and Dietary Variety Score (odds ratio 0.95, 95% confidence interval 0.92-0.98) were significantly associated with oral frailty. The path analysis showed individual associations between each examined factor. CONCLUSIONS Oral frailty was associated with decreased appetite and dietary variety in late-stage older adults. Geriatr Gerontol Int 2024; 24: 626-633.
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Affiliation(s)
- Sayuri Nakagawa
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kazuhito Miura
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Eri Arai
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kenshu Taira
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Takahiro Ono
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | | | | | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
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Yu J, Zhu H, Zhang Y, Wang D, Guo H, Liu X. Research hotspots and trends of oral health in older adults from 2013 to 2023: A bibliometric and visual analysis. Heliyon 2024; 10:e25243. [PMID: 38322931 PMCID: PMC10845922 DOI: 10.1016/j.heliyon.2024.e25243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Background Oral health problems seriously affect the quality of life of older adults. It is of great significance to investigate the statuses of oral health in older adults. The study aimed to analyze the current status, hotspots and frontiers of global oral health research in older adults through bibliometrics to provide references and guidance for future research in this field. Methods Literature on oral health in older adults from 2013 to 2023 was retrieved from the Web of Science Core Collection (WoSCC) database. CiteSpace 6.2.R4 was used for bibliometric and visual analysis, including journal and co-cited journal, country/region, institution, author, co-cited references, and keyword analysis. Results A total of 1430 publications related to oral health in older adults were included. The number of publications has gradually increased over the past decade. The most widely published and cited journal was Gerodontology. The most prominent contribution came from the United States of America, and the University of London and Hirohiko Hirano were the most prolific institution and author, respectively. The current research hotspots were summarized as oral hygiene interventions, oral health-related quality of life and oral health issues in older adults. Cohort studies of oral health, the relationship between oral health and frailty, and the correlation between oral health and nutritional status may be emerging research trends. Conclusions This study systematically analyzed the hotspots and frontiers of oral health in older adults and called for increased collaboration among countries, institutions, and authors. In addition, oral hygiene interventions for older adults, oral health-related quality of life, oral health issues, cohort studies of oral health, and the relationship between oral health and frailty or nutritional status may be the focus of future research.
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Affiliation(s)
- Jianjiao Yu
- Department of Nursing, Shaanxi Provincial People's Hospital, 710068, Xi'an, Shaanxi, China
- School of Nursing, Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Huolan Zhu
- Department of Geriatrics, Shaanxi Provincial People's Hospital, 710068, Xi'an, Shaanxi, China
- Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Shaanxi Provincial People's Hospital, 710068, Xi'an, Shaanxi, China
| | - Yulian Zhang
- Director's Office, Shaanxi Provincial People's Hospital, 710068, Xi'an, Shaanxi, China
| | - Dan Wang
- Department of Nursing, Shaanxi Provincial People's Hospital, 710068, Xi'an, Shaanxi, China
| | - Hua Guo
- Department of Nursing, Shaanxi Provincial People's Hospital, 710068, Xi'an, Shaanxi, China
| | - Xiaomei Liu
- Department of Nursing, Shaanxi Provincial People's Hospital, 710068, Xi'an, Shaanxi, China
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Nicolas-Rodriguez E, Pons-Fuster E, López-Jornet P. Diagnostic Infrared Thermography of the Tongue and Taste Perception in Patients with Oral Lichen Planus: Case-Control Study. J Clin Med 2024; 13:435. [PMID: 38256569 PMCID: PMC10816281 DOI: 10.3390/jcm13020435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/31/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease of autoimmune origin that affects the skin and mucous membranes. The aim of this study was to assess the effectiveness of infrared thermography (IRT) as a diagnostic tool in patients with oral lichen planus (OLP), as well as disturbances in taste perception, in cases with and without tongue involvement. A case-control study was carried out in a sample of 87 patients divided into three groups: healthy individuals (controls; n = 43), OLP patients without involvement of the tongue (n = 24), and OLP patients with involvement of the tongue (n = 20). The patient symptoms and the clinical characteristics of the lesions were assessed. Four thermal images of the tongue were obtained using IRT: dorsum, right and left lateral surface, and tip of the tongue. General taste perception capacity and subjective sweet, acid, salty, and bitter sensation were evaluated in all three groups. There were no statistically significant differences in the IRT values among the three groups (p ≥ 0.05). In the OLP patients with involvement of the tongue, significantly higher values were observed in the mixed forms of the disease (p = 0.032). The OLP patients with and without involvement of the tongue showed no significant alterations in taste sensation (p = 0.69). IRT may serve as a complementary tool for assessing the activity of OLP with involvement of the tongue. However, more research is needed in this field.
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Affiliation(s)
- Elena Nicolas-Rodriguez
- Faculty of Medicine and Odontology, Hospital Morales Meseguer, Clínica Odontológica, Marqués del Los Vélez s/n, 30008 Murcia, Spain;
| | - Eduardo Pons-Fuster
- Departamento de Anatomía Humana y Psicobiología, Faculty of Medicine and Odontology, Biomedical Research Institute (IMIB-Arrixaca), University of Murcia Spain, 30100 Murcia, Spain;
| | - Pia López-Jornet
- Faculty of Medicine and Odontology, Hospital Morales Meseguer, Clínica Odontológica, Marqués del Los Vélez s/n, 30008 Murcia, Spain;
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Marinkovic M, Tran ON, Wang H, Abdul-Azees P, Dean DD, Chen XD, Yeh CK. Autologous mesenchymal stem cells offer a new paradigm for salivary gland regeneration. Int J Oral Sci 2023; 15:18. [PMID: 37165024 PMCID: PMC10172302 DOI: 10.1038/s41368-023-00224-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/20/2023] [Accepted: 03/29/2023] [Indexed: 05/12/2023] Open
Abstract
Salivary gland (SG) dysfunction, due to radiotherapy, disease, or aging, is a clinical manifestation that has the potential to cause severe oral and/or systemic diseases and compromise quality of life. Currently, the standard-of-care for this condition remains palliative. A variety of approaches have been employed to restore saliva production, but they have largely failed due to damage to both secretory cells and the extracellular matrix (niche). Transplantation of allogeneic cells from healthy donors has been suggested as a potential solution, but no definitive population of SG stem cells, capable of regenerating the gland, has been identified. Alternatively, mesenchymal stem cells (MSCs) are abundant, well characterized, and during SG development/homeostasis engage in signaling crosstalk with the SG epithelium. Further, the trans-differentiation potential of these cells and their ability to regenerate SG tissues have been demonstrated. However, recent findings suggest that the "immuno-privileged" status of allogeneic adult MSCs may not reflect their status post-transplantation. In contrast, autologous MSCs can be recovered from healthy tissues and do not present a challenge to the recipient's immune system. With recent advances in our ability to expand MSCs in vitro on tissue-specific matrices, autologous MSCs may offer a new therapeutic paradigm for restoration of SG function.
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Affiliation(s)
- Milos Marinkovic
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Olivia N Tran
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hanzhou Wang
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Parveez Abdul-Azees
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - David D Dean
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| | - Xiao-Dong Chen
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Research Service, South Texas Veterans Health Care System, San Antonio, TX, USA.
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, TX, USA.
| | - Chih-Ko Yeh
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Geriatric Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, USA.
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Guimarães DDM, Parro YM, Muller HS, Coelho EB, Martins VDP, Santana R, Lia ÉN. Xerostomia and dysgeusia in the elderly: prevalence of and association with polypharmacy. BRAZILIAN JOURNAL OF ORAL SCIENCES 2023. [DOI: 10.20396/bjos.v22i00.8666637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Xerostomia is defined as the perception of dry mouth, and dysgeusia, as a change in taste. Both are common complaints in the elderly, especially among those making use of polypharmacy drug combinations. Aim: This study aimed to determine the prevalence of xerostomia and dysgeusia and to investigate their association with polypharmacy in the elderly. Methods: older people under follow-up at the Multidisciplinary Elderly Center of the University Hospital of Brasília were interviewed and asked about health problems, medications used, presence of xerostomia and dysgeusia. Descriptive statistics were used to determine the prevalence of the symptoms surveyed. The chi-square test was used to investigate the relationship between xerostomia and dysgeusia and polypharmacy. Secondary associations were performed using binomial logistic regression. Results: Ninety-six older people were evaluated and of these, 62.5% had xerostomia and 21.1%, had dysgeusia. The average number of medications used was 4±3 medications per individual. Polypharmacy was associated with xerostomia but not dysgeusia. It was possible to associate xerostomia with the use of antihypertensive drugs. Conclusion: Xerostomia was a frequent complaint among elderly people making use of polypharmacy, especially those using antihypertensives. Antihypertensives and antidepressants were used most drugs by the elderly and exhibited interactions with drugs most prescribed in Dentistry. Two contraindications were found between fluconazole and mirtazapine; and between erythromycin and simvastatin.
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Cannon I, Robinson-Barella A, McLellan G, Ramsay SE. From Drugs to Dry Mouth: A Systematic Review Exploring Oral and Psychological Health Conditions Associated with Dry Mouth in Older Adults with Polypharmacy. Drugs Aging 2023; 40:307-316. [PMID: 36943673 DOI: 10.1007/s40266-023-01017-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Approximately 60% of older adults complain of dry mouth, which may be associated with polypharmacy, common in this population. Existing studies have reported treatment approaches to dry mouth but do not address long-term preventative measures that would more positively benefit the health and well-being of older adults. OBJECTIVE We aimed to explore the consequences of dry mouth, associated with polypharmacy, on the physical and psychological health of older adults in order to establish the importance of preventing dry mouth. METHODS This systematic review was conducted of studies reporting health conditions of dry mouth, in relation to polypharmacy in older adults (aged ≥ 65 years). MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched using keywords such as 'polypharmacy', 'dry mouth', 'oral health' and 'quality of life' (PROSPERO: CRD42021288945). Joanna Briggs Institute critical appraisal tools were used to assess study quality. RESULTS Of the 6852 citations screened, nine studies (cross-sectional, n = 8; longitudinal, n = 1) were included that comprised 37,459 participants (mean age range 68.5-85.0 years). Studies were published between 2005 and 2019. Because of the heterogeneity of reported study outcomes, a narrative synthesis was undertaken. The health conditions identified in this review were categorised as 'physical' or 'psychological'. The main physical health conditions reported in the studies related to dental health, such as tooth loss, and functional impairments, such as swallowing difficulties. An increase in the number of medicines taken, from 0 to 5, decreased the number of natural teeth remaining from 16 (standard deviation [SD] ± 9) to 12 (SD ± 8), respectively. Additionally, the number of dental complications increased from 1 (SD ± 2) to 2 (SD ± 2) as the number of medicines increased from 1 to ≥ 3. There was a paucity of studies (n = 2) that investigated psychological health conditions of dry mouth among older adults, with depression identified as a significant issue among older adults with dry mouth (where the reported prevalence was as high as 64%). An additional six psychological health conditions were identified: self-consciousness, feeling tense, difficulty relaxing, irritability, difficulty completing tasks and feeling less satisfied in life. CONCLUSIONS High levels of physical health conditions of dry mouth are observed in older adults and, to a lesser extent, psychological health conditions. These conditions can negatively affect quality of life. There remains a need to prevent dry mouth and the adverse health conditions associated with it in older adults. The modifiable nature of polypharmacy could be targeted to minimise, and potentially prevent, dry mouth. The optimisation of medication regimes to effectively treat chronic conditions, but also limit the likelihood of dry mouth, is a practical approach. Dry mouth prevention should be a priority and polypharmacy can pave the way for prevention strategies, avoiding the need to treat dry mouth.
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Affiliation(s)
- India Cannon
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Anna Robinson-Barella
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Gillian McLellan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Battini V, Rocca S, Guarnieri G, Bombelli A, Gringeri M, Mosini G, Pozzi M, Nobile M, Radice S, Clementi E, Schindler A, Carnovale C, Pizzorni N. On the potential of drug repurposing in dysphagia treatment: New insights from a real-world pharmacovigilance study and a systematic review. Front Pharmacol 2023; 14:1057301. [PMID: 36937893 PMCID: PMC10022593 DOI: 10.3389/fphar.2023.1057301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/30/2023] [Indexed: 03/06/2023] Open
Abstract
Background: Polypharmacy is common in patients with dysphagia. Routinely used drugs may influence swallowing function either improving or worsening it. We aimed to explore the potential effects of three commonly used drug classes on dysphagia and aspiration pneumonia through a systematic review and a real-world data analysis to probe the possibility of drug repurposing for dysphagia treatment. Material and Methods: Five electronic databases were searched. Studies on adults at risk for dysphagia, treated with Dipeptidyl-Peptidase IV Inhibitors (DPP-4i), Adrenergic Beta-Antagonists (beta-blockers), or Angiotensin-Converting Enzyme Inhibitors (ACEi), and reporting outcomes on dysphagia or aspiration pneumonia were included. A nested case/non-case study was performed on adverse events recorded in the FDA Adverse Event Reporting System (FAERS) on patients >64 years. Cases (dysphagia or aspiration pneumonia) were compared between patients only treated with Levodopa and patients who were concomitantly treated with the drugs of interest. Results: Twenty studies were included in the review (17 on ACEi, 2 on beta-blockers, and 1 on DPP-4i). Contrasting findings on the effects of ACEi were found, with a protective effect mainly reported in Asian studies on neurological patients. Beta-blockers were associated with a reduced dysphagia rate. The study on DPP-4i suggested no effect on dysphagia and an increased risk of aspiration pneumonia. The FAERS analysis showed a reduction of the risk for dysphagia/aspiration pneumonia with ACEi, beta-blockers, and DPP-4i. Conclusion: Our study explores the potential drug repurposing of ACEi, beta-blockers and DPP-4i in neurological patients with dysphagia to improve swallowing function and reduce aspiration pneumonia risk. Future randomized controlled studies should confirm these results and clarify the underlying mechanisms of action.
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Affiliation(s)
- Vera Battini
- Department of Biomedical and Clinical Sciences, Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Sara Rocca
- Phoniatric Unit, Department of Biomedical and Clinical Sciences, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Greta Guarnieri
- Department of Biomedical and Clinical Sciences, Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Anna Bombelli
- Department of Biomedical and Clinical Sciences, Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Michele Gringeri
- Department of Biomedical and Clinical Sciences, Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Giulia Mosini
- Department of Biomedical and Clinical Sciences, Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Marco Pozzi
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini(LC), Italy
| | - Maria Nobile
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini(LC), Italy
| | - Sonia Radice
- Department of Biomedical and Clinical Sciences, Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Emilio Clementi
- Department of Biomedical and Clinical Sciences, Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini(LC), Italy
| | - Antonio Schindler
- Phoniatric Unit, Department of Biomedical and Clinical Sciences, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Carla Carnovale
- Department of Biomedical and Clinical Sciences, Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
- *Correspondence: Carla Carnovale,
| | - Nicole Pizzorni
- Phoniatric Unit, Department of Biomedical and Clinical Sciences, “Luigi Sacco” University Hospital, Università degli Studi di Milano, Milan, Italy
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The Influence of Nutritional Status and Sleep Quality on Gustatory Function in Older Adults. MEDICINA (KAUNAS, LITHUANIA) 2022; 59:medicina59010041. [PMID: 36676665 PMCID: PMC9863202 DOI: 10.3390/medicina59010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022]
Abstract
Background and Objectives: Age-related declines in taste function are common. Taste acuity can be affected by nutritional status and sleep quality. This research aims to examine the effect of nutritional status and sleep quality on gustatory function in community-dwelling older adults. Materials and Methods: This cross-sectional study included 119 community-dwelling older adults (50.4% of whom were female). The gustatory function was evaluated using four liquid taste solutions (sweet, bitter, sour, and salty) each at four different concentrations and the Mini Nutritional Assessment (MNA) and Pittsburgh Sleep Quality Index (PSQI) was applied. Additionally, anthropometric measurements were taken. Results: The mean scores on the gustatory test for the sweet, bitter, sour, and salty tastes were 2.11 ± 1.27, 2.12 ± 1.03, 2.28 ± 1.03, and 1.98 ± 1.41, respectively. There were significant differences according to gender, polypharmacy, nutritional status, and sleep quality in identifying sweet tastes (all p < 0.05). It was also found that females and participants without polypharmacy had better scores for bitter tastes. When the gustatory functions were evaluated according to BMI classification, it was determined that underweight participants had a higher sour taste score than the obese ones. Multiple regression analysis revealed that age, MNA score, PSQI score, and gender accounted for a total of 20.4% of the variance in the sweet taste score. Conclusions: Determining the relationship between taste function, nutritional status, and sleep quality in older adults is important in terms of developing new strategies for older adults who have these problems.
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Michalak P, Polak-Szlósarczyk P, Dyduch-Dudek W, Kęsek B, Zarzecka-Francica E, Styrna M, Czekaj Ł, Zarzecka J. Oral and Mucosal Complaints among Institutionalized Care Seniors in Malopolska Voivodeship-The Utility of the Mirror Sliding Test in an Assessment of Dry Mouth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113776. [PMID: 36360656 PMCID: PMC9657787 DOI: 10.3390/ijerph192113776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 05/13/2023]
Abstract
The purpose of this article was to evaluate reported oral and mucosal complaints among seniors residing in institutionalized 24-h care of the Municipal Center for Older and Dependent People (MHCOD) and the 3-month rehabilitation program of the Daily Medical Care House (DMCH). We evaluated the feasibility of using the dental mirror slidding test to assess dry mouth of seniors. Patients underwent a questionnaire, and clinical examination. The Visual Analogue Scale (VAS) was used to assess pain, Fox's questionnaire and Challacombe's scale with Clinical Oral Dryness Score to assess dryness of the mouth, dental mirror slidding test to assess buccal mucosal resistance. Dryness, mucosal burning, impaired taste, food intake are symptoms associated with seniors, and their frequency does not depend on the type of care. The incidence of mucosal burning (Mdn = 4.0, IQR = 4.75, p = 0.032) and difficulty in using dental prosthetics (Mdn = 3.0, IQR = 4.00, p = 0.010) increase with the length of stay at MHCOD. Seniors are at risk of side effects of polypharmacy, which cause dryness (p = 0.036), complaints of lack of saliva (p = 0.009) and taste disorders (p = 0.041. Seniors with higher levels of dry mouth are more likely to exhibit mucosal burning (p = 0.026) and difficulty in taking food (p = 0.037). The implementation of the dental mirror slidding test in the scope of the primary care of geriatric examination should be discussed.
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Affiliation(s)
- Piotr Michalak
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
- Correspondence: ; Tel.: +48-607-505-906
| | - Paulina Polak-Szlósarczyk
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Wioletta Dyduch-Dudek
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Barbara Kęsek
- Department of Periodontology, Clinical Oral Pathology and Prophylaxis, Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Elżbieta Zarzecka-Francica
- Department of Prosthodontics and Orthodontics, Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Maria Styrna
- Municipal Health Centre for Older and Dependent Individuals, 30663 Krakow, Poland
| | - Łukasz Czekaj
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
| | - Joanna Zarzecka
- Department of Conservative Dentistry with Endodontics Institute of Stomatology, Faculty of Medicine, Medical College, Jagiellonian University, 31008 Krakow, Poland
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Marquezin MCS, de Oliveira Scudine KG, Lamy E, Finassi CM, Carreira L, Segura WD, Rasera I, Pessotti ER, Castelo PM. Impact of gastroplasty on salivary characteristics, dental health status and oral sensory aspects: a controlled clinical study. J Oral Rehabil 2022; 49:1002-1011. [PMID: 35751503 DOI: 10.1111/joor.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 04/29/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Saliva is a non-invasive source of biomarkers useful in the study of different pathophysiological conditions. The qualitative and quantitative study of saliva, as well as the assessment of oral health, can be particularly useful for a better understanding of obesity due to its importance in the food oral perception and ingestion. OBJECTIVES To evaluate the effect of treatment of morbid obesity (dietary counselling versus gastroplasty) on salivary characteristics, oral sensory perception and dental health in a controlled study. METHODS 73 adults (60 females; 19-59 years) with morbid obesity were divided in: Control group (CG; n=34) followed-up during a 6-months dietary program, and Gastroplasty group (GG; n=39) evaluated immediately before, 3, and 6 months after gastroplasty. Dietary habits, Oral Health Impact Profile and xerostomia complaints were investigated by interview. The clinical examination included anthropometric and caries experience evaluation. Salivary flow rate, buffering capacity, total protein and alpha-amylase levels, and sensitivity for the 4 basic tastes were assessed. Two-way mixed model and sign test were applied. RESULTS Physical and clinical aspects did not differ between groups in the beginning of the study, and GG showed a rapid weight loss after surgery (p<0.001). An improvement in most of the dietary aspects was observed, especially in the GG. A worsening in the dental health status was observed over time in both groups, with an increase in the number of filled and decayed teeth. CG showed a better oral health-related quality of life, while xerostomia complains increased in GG after gastroplasty. Salivary flow rate remained stable in both groups, but a decrease in buffering capacity, total protein, and alpha-amylase activity was observed in GG after 6-months; taste sensitivity increased from baseline to 6-months in GG (p<0.05). CONCLUSION After 6-months of follow-up, patients undergoing gastroplasty presented an improvement in dietary habits and taste sensitivity. However, changes in saliva composition and a worsening in dental health status and xerostomia complaints were also observed.
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Affiliation(s)
- Maria Carolina Salomé Marquezin
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Kelly Guedes de Oliveira Scudine
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Elsa Lamy
- MED-Mediterranean Institute for Agriculture, Environment and Development & CHANGE-Global Change and Sustainability Institute, University of Évora, Portugal
| | - Carolina Martins Finassi
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Laura Carreira
- MED-Mediterranean Institute for Agriculture, Environment and Development & CHANGE-Global Change and Sustainability Institute, University of Évora, Portugal
| | - Wilson Dias Segura
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Irineu Rasera
- Faculdade de Ensino Superior da Amazônia Reunida (FESAR/AFYA), Brazil
| | | | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Brazil
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Burnip E, Cichero JAY. Review of the effect of amylase-resistant dysphagia products on swallowing safety. Curr Opin Otolaryngol Head Neck Surg 2022; 30:169-176. [PMID: 35635111 DOI: 10.1097/moo.0000000000000799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Thickened fluids are a widely utilised compensatory management strategy for people with impaired swallowing (dysphagia). Over recent years there has been a shift in practice to offer gum-based instead of starch-based products. A key marketing message has been that gum-based thickeners with amylase-resistant properties are superior in promoting 'safer swallowing'. This review sought evidence to evaluate the effect of amylase-resistant products on swallowing safety. RECENT FINDINGS No studies directly compared the effect of amylase-resistant products with usual care or products without amylase resistance. Five studies cited amylase-resistant properties and compared gum-based to starch-based dysphagia products or thin fluids. Swallowing safety was frequently judged subjectively with rating scales. Swallowing biomechanics were not included and clinically meaningful outcomes, such as incidence of aspiration pneumonia, were not reported. A scoping review of the grey literature found little evidence that amylase-resistant properties of dysphagia products were of significant concern to clinicians or patients. SUMMARY Despite references to the 'importance' of amylase-resistant properties of dysphagia products there is no evidence that this property improves swallowing safety. Further research is needed using objective and clinically meaningful outcome measures to allow clinicians and patients to make informed decisions for dysphagia management.
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Affiliation(s)
- E Burnip
- University of Canterbury, New Zealand
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Ambrosio-Palma A, Avila-Funes JA, Mimenza-Alvarado A, Serralde-Zúñiga AE, Zavala-Solares M, Aguilar-Navarro S. Prevalence and Biological Correlates of Oropharyngeal Dysphagia in Outpatients of a Geriatric Evaluation Clinic: A Brief Report. Gerontology 2021; 68:682-685. [PMID: 34515126 DOI: 10.1159/000518559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/19/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Oropharyngeal dysphagia (OD) is a relevant disease among older adults and is associated with serious adverse health-related outcomes, such as malnutrition, sarcopenia, or frailty. Increasing its recognition and the related mechanisms will allow us to its prevention and treatment at different levels of care. OBJECTIVES This study aimed to determine the prevalence and biological correlates of OD in outpatient older adults. METHOD This is a cross-sectional study including 100 adults aged 60 or older from a geriatric clinic of a tertiary hospital in Mexico City. Health variables and geriatric syndromes were recorded. The Eating Assessment Tool-10 detection test and the volume-viscosity swallowing test were used to diagnose OD. Logistic regression models were performed to identify the factors associated with OD. RESULTS Mean age was 81.2 (±7.5) years and 21% had OD. The presence of xerostomia (p = 0.05) and a worst nutritional status (p = 0.035) were obtained. CONCLUSIONS The prevalence of OD among older adults was high. Inadequate nutrition status and the presence of xerostomia are more likely to be present with this swallowing disorder.
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Affiliation(s)
- Abdias Ambrosio-Palma
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico,
| | - Jose Alberto Avila-Funes
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France
| | - Alberto Mimenza-Alvarado
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Mónica Zavala-Solares
- Department of Clinical Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sara Aguilar-Navarro
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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