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Assessment of Dysphagia and Sarcopenia for Nutritional Applications: Practical Implications for Malnourished Older Patients Who Require Rehabilitation

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Book cover Handbook of Famine, Starvation, and Nutrient Deprivation

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Abstract

Dysphagia is caused by various diseases and results in malnutrition, dehydration, and death. Dysphagia screening tools, a method for classifying severity, and a diagnostic test are necessary to identify and treat dysphagia in older adults with disabilities. The Eating Assessment Tool-10, water swallowing test, the repetitive saliva swallowing test, pulse oximetry, and cervical auscultation are used commonly in clinical practice to screen for dysphagia. Assessing dysphagia severity using the functional oral intake scale and the Food Intake LEVEL Scale are recommended for classifying patients’ swallowing function and deciding therapeutic strategies. Videofluorography and fiber-optic endoscopic evaluation of swallowing are considered to be the gold standard for definite dysphagia. Sarcopenia potentially causes dysphagia, namely sarcopenic dysphagia, in which it is difficult to swallow due to sarcopenia of the generalized and swallowing muscles. Both rehabilitation and nutritional care should be used to treat sarcopenic dysphagia, based on the concept of rehabilitation nutrition. Rehabilitation nutrition includes comprehensive evaluation and intervention using rehabilitation and nutritional care of people with disabilities. It is necessary to first screen for dysphagia in older adults and then classify its severity and/or make a dysphagia diagnosis. Sarcopenia should be classified using consensus-based criteria such as the European Working Group on Sarcopenia in Older People or the Asian Working Group for Sarcopenia. Malnutrition can cause dysphagia or delayed recovery of swallowing function. Validated nutritional screening tools are useful. It is important to recognize that older adults with malnutrition require evaluation of dysphagia and sarcopenia in clinical practice.

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Abbreviations

ADL:

Activities of daily living

AWGS:

Asian Working Group for Sarcopenia

DSS:

Dysphagia Severity Scale

EAT-10:

Eating Assessment Tool-10

EWGSOP:

European Working Group on Sarcopenia in Older People

FEES:

Fiber-optic endoscopic evaluation of swallowing

FILS:

Food Intake LEVEL Scale

FOIS:

Functional oral intake scale

ICF:

International Classification of Functioning, Disability and Health

MNA:

Mini Nutritional Assessment

MUST:

Malnutrition Universal Screening Tool

MWST:

Modified water swallowing test

NRS2002:

Nutritional Risk Screening

QOL:

Quality of life

RSST:

Repetitive saliva swallowing test

SGA:

Subjective Global Assessment

VF:

Videofluorography

WST:

Water swallowing test

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Acknowledgments

This article was supported by a research Grant-in-Aid for Scientific Research C (no. 16 K01460) from the Ministry of Education, Science, Culture, Sports, Science, and Technology of Japan.

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Authors and Affiliations

  1. Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan

    Shinta Nishioka

  2. Department of Training and Development of Staffs, Nagasaki Rehabilitation Hospital, Nagasaki, Japan

    Yuka Okazaki

  3. Department of Rehabilitation Medicine, Yokohama city university medical center, Yokohama, Kanagawa, Japan

    Hidetaka Wakabayashi

Authors
  1. Shinta Nishioka
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  2. Yuka Okazaki
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  3. Hidetaka Wakabayashi
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Corresponding author

Correspondence to Shinta Nishioka .

Editor information

Editors and Affiliations

  1. Diabetes and Nutritional Sciences Research Division, Faculty of Life Science and Medicine, King’s College London, London, UK

    Victor R. Preedy

  2. School of Life Sciences, University of Westminster, London, UK

    Vinood B. Patel

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Nishioka, S., Okazaki, Y., Wakabayashi, H. (2019). Assessment of Dysphagia and Sarcopenia for Nutritional Applications: Practical Implications for Malnourished Older Patients Who Require Rehabilitation. In: Preedy, V., Patel, V. (eds) Handbook of Famine, Starvation, and Nutrient Deprivation. Springer, Cham. https://doi.org/10.1007/978-3-319-55387-0_28

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  • DOI: https://doi.org/10.1007/978-3-319-55387-0_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-55386-3

  • Online ISBN: 978-3-319-55387-0

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