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. 16Â K01460) from the Ministry of Education, Science, Culture, Sports, Science, and Technology of Japan.
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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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