title: Capsaicin troche for swallowing dysfunction in older people.
abstract: OBJECTIVE
  To determine whether oral capsaicin troche supplementation with every meal upregulates the impairment of upper respiratory protective reflexes such as the swallowing reflex and the cough reflex.
  
  
  METHODS
  Randomized, controlled study with recruitment through nursing homes.
  
  
  METHODS
  Sendai, Japan, from September 2002 through December 2003.
  
  
  METHODS
  Sixty-four participants in nursing homes with a mean age+/-standard deviation of 81.9+/-1.0 with stable physical status.
  
  
  METHODS
  Participants were randomly assigned to the program for the supplementation of capsaicin trochisci or placebo trochisci before every meal for 4 weeks.
  
  
  METHODS
  Assessment of individual latency time of the swallowing reflex (LTSR) and cough reflex sensitivity.
  
  
  RESULTS
  Before the commencement of this study, there were no significant baseline differences in multiple parameters between the intervention group and control group. LTSR in participants in the intervention group was significantly shorter than in the control group (P<.05). The odds ratio (OR) of the shortening of the LTSR of more than 1 minute in the intervention group was 3.4 (95% confidence interval (CI)=1.1-10.4), compared with the control group (P=.03). In particular, daily capsaicin supplementation significantly increased the ratio of LTSR reduction at 4 weeks after the study to baseline LTSR in the high-risk group (baseline LTSR >6.0 seconds) compared with the low-risk group (baseline LTSR <3.0 seconds) and the intermediate group (3.0 seconds <baseline LTSR <6.0 seconds) (P<.005). Seventeen (52.1%) participants in the intervention group and seven (21.9%) in the control group showed improvement in cough reflex sensitivity (OR=4.1, 95% CI=1.4-12.2; P<.01).
  
  
  CONCLUSIONS
  Daily capsaicin supplementation resulted in a significant improvement in upper protective respiratory reflexes, particularly in older people with a high risk for aspiration.
authors.affiliation: Department of Geriatric and Respiratory Medicine, Tohoku University School of Medicine, Sendai, Japan. takae_Montreal@hotmail.com
authors.forename: Takae
authors.initials: T
authors.lastname: Ebihara
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takahashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Ebihara
authors.forename: Tatsuma
authors.initials: T
authors.lastname: Okazaki
authors.forename: Takahiko
authors.initials: T
authors.lastname: Sasaki
authors.forename: Aya
authors.initials: A
authors.lastname: Watando
authors.forename: Miyako
authors.initials: M
authors.lastname: Nemoto
authors.forename: Hidetada
authors.initials: H
authors.lastname: Sasaki
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D002211:Capsaicin / Q000008:administration & dosage*; D003679:Deglutition / Q000187:drug effects; D003680:Deglutition Disorders / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D011930:Reaction Time / Q000187:drug effects; D012018:Reflex / Q000187:drug effects; D013607:Tablets; D015854:Up-Regulation
chemical_list: D013607:Tablets; D002211:Capsaicin