高齢者の嚥下障害の管理と栄養

高齢者の嚥下障害の管理と栄養に関するレビュー論文を紹介します。

Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly: management and nutritional considerations. Clinical Interventions in Aging, Volume 2012:287 - 298, DOI: http://dx.doi.org/10.2147/CIA.S23404

下記HPで全文PDFをダウンロードすることができます。

http://www.dovepress.com/dysphagia-in-the-elderly-management-and-nutritional-considerations-peer-reviewed-article-CIA

加齢、脳卒中、認知症による嚥下機能低下と栄養状態との関連について、よくまとまっているレビュー論文と思います。嚥下リハはもちろん有効ですが、栄養改善や肺炎発症率減少の効果も示されています。個人的には、脳卒中、認知症、サルコペニアが嚥下リハで最も問題となると考えています。

Abstract:
Dysphagia is a prevalent difficulty among aging adults. Though increasing age facilitates subtle physiologic changes in swallow function, age-related diseases are significant factors in the presence and severity of dysphagia. Among elderly diseases and health complications, stroke and dementia reflect high rates of dysphagia. In both conditions, dysphagia is associated with nutritional deficits and increased risk of pneumonia. Recent efforts have suggested that elderly community dwellers are also at risk for dysphagia and associated deficits in nutritional status and increased pneumonia risk. Swallowing rehabilitation is an effective approach to increase safe oral intake in these populations and recent research has demonstrated extended benefits related to improved nutritional status and reduced pneumonia rates. In this manuscript, we review data describing age related changes in swallowing and discuss the relationship of dysphagia in patients following stroke, those with dementia, and in community dwelling elderly. Subsequently, we review basic approaches to dysphagia intervention including both compensatory and rehabilitative approaches. We conclude with a discussion on the positive impact of swallowing rehabilitation on malnutrition and pneumonia in elderly who either present with dysphagia or are at risk for dysphagia.