Diagnosis and Management of Oropharyngeal Dysphagia and Its Nutritional and Respiratory Complications in the Elderly

Gastroenterology Research and Practice - Tập 2011 - Trang 1-13 - 2011
Laia Rofes1, Viridiana Arreola2, Jordi Almirall3,4, Mateu Cabré5, Lluís Campins6, Pilar García-Peris7, Reneé Speyer8,9, Père Clavé1,2
1Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Instituto de Salud Carlos III, 08036 Barcelona, Spain
2Unidad de Exploraciones Funcionales Digestivas, Hospital de Mataró, 08304 Mataró, Spain
3Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (Ciberes), Instituto de Salud Carlos III, 07110 Mallorca, Spain
4Unidad de Cuidados Intensivos, Hospital de Mataró, 08304 Mataró, Spain
5Unidad Geriátrica de Adultos, Hospital de Mataró, 08304 Mataró, Spain
6Servicio de Farmacia, Hospital de Mataró, 08304 Mataró, Spain
7Nutrition Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
8Comprehensive Cancer Centre West, 2316 XB Leiden, The Netherlands
9Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands

Tóm tắt

Oropharyngeal dysphagia is a major complaint among older people. Dysphagia may cause two types of complications in these patients: (a) a decrease in the efficacy of deglutition leading to malnutrition and dehydration, (b) a decrease in deglutition safety, leading to tracheobronchial aspiration which results in aspiration pneumonia and can lead to death. Clinical screening methods should be used to identify older people with oropharyngeal dysphagia and to identify those patients who are at risk of aspiration. Videofluoroscopy (VFS) is the gold standard to study the oral and pharyngeal mechanisms of dysphagia in older patients. Up to 30% of older patients with dysphagia present aspiration—half of them without cough, and 45%, oropharyngeal residue; and 55% older patients with dysphagia are at risk of malnutrition. Treatment with dietetic changes in bolus volume and viscosity, as well as rehabilitation procedures can improve deglutition and prevent nutritional and respiratory complications in older patients. Diagnosis and management of oropharyngeal dysphagia need a multidisciplinary approach.

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Gastroenterology Research and Practice

Tập 2011

1-13

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