EAT-10による高齢者の嚥下障害の有病割合

EAT-10日本語版は以下のHPからダウンロード可能です。
www.maff.go.jp/j/shokusan/seizo/kaigo/pdf/eat-10.pdf

EAT-10で高齢者の嚥下障害の有病割合を調査した報告を紹介します。

M. Ercilla, C. Ripa, M. Gayan, J.M. Arteche, B. Odriozola, M.C. Bello, I. Barral. Prevalence of dysphagia in the older using ‘Eating Assessment Tool-10’. Eur J Hosp Pharm 2012;19:205-206 doi:10.1136/ejhpharm-2012-000074.316

対象は高齢者病棟に入院している高齢者からランダムに選択した50人（平均年齢78歳）で、嚥下障害はEAT-10で評価し、栄養状態はCONUTで評価しました。結果ですが、EAT-10が3点以上で異常と判定されたのは10人（20％、平均11.7点、幅3－31点）でした。

EAT-10の実施には平均4分かかりました。10人中4人で嚥下障害への対応がされていて、食形態の工夫4人、増粘剤3人で、ゼラチンを使用している人はいませんでした。嚥下障害の10人中8人がCONUTで低栄養（軽度5人、中等度3人）と判定されました。

以上より、高齢者の2割で嚥下障害を認めましたが、嚥下障害への対応がされていたのはそのうち4割のみでした。嚥下障害者の8割に低栄養を認めました。EAT-10の実施は容易なので、高齢者にはルーチンで評価して、嚥下障害に対応できることが望ましいという結論です。

EAT-10を使用した論文はあまりないので、この点では貴重な情報かと思います。ただ、この程度のことであればすでに日本でもデータを出せますので、日本からもEAT-10について情報発信していかなければと感じました。

Abstract

Background Dysphagia is a symptom whose prevalence can be higher than 30% in the older. It is related to higher disability, longer hospital stay and more malnutrition and mortality. The Eating Assessment Tool (EAT-10) is a practical, analogical and easy dysphagia evaluation instrument.

Purpose Determine the prevalence of dysphagia in the older. Evaluate if it was previously detected by the physician and if he established corrective actions. Assess the nutritional status in patients with dysphagia.

Materials and methods 50 patients, 18 male and 32 female, were randomly selected in an older patient unit. Medium age was 78. Dysphagia was measured with EAT-10, a 10 question questionnaire (each scored from 0 to 4). If total score is ≥3, dysphagia may be present. The type of diet as well as gelatin and thickeners intake was registered. Nutritional status was assessed by CONUT (COntrol NUTritional) system. Unlike Nutritional Risk Screening (NRS-2002) which is a screening tool based on weight loss, Body Mass Index, food intake diminution and disease severity, CONUT is an automatic validated tool that classifies nutritional status in normal, mild, moderate or serious malnutrition, based on serum albumin, cholesterol and lymphocytes.

Results EAT-10 was ≥3 in 10 patients (20%) (mean =11,7; range 3-31). Average realisation time was 4 min. Four patients (40%) with EAT-10 ≥3 had corrective actions. All had crushed diet, and 3 had thickeners. None had gelatins. Eight patients out of ten with dysphagia had malnutrition (5 mild, 3 moderate). All patients with moderate malnutrition had nutritional supplements.

Conclusions 20% of patients had dysphagia, but only 40% had corrective actions. Malnutrition prevalence was high (80%) in patients with dysphagia. EAT-10 is an easy and fast dysphagia detecting scale and could avoid malnutrition and other associated problems. So, it would be advisable its routine realisation in older so that corrective actions are established.