Diagnosis and management of oropharyngeal Dysphagia and its nutritional and respiratory complications in the elderly.
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.
Rofes
Laia
L
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Instituto de Salud Carlos III, 08036 Barcelona, Spain.
Arreola
Viridiana
V
Almirall
Jordi
J
Cabré
Mateu
M
Campins
Lluís
L
García-Peris
Pilar
P
Speyer
Renée
R
Clavé
Pere
P
Clin Nutr. 2006 Apr;25(2):330-60
16735082
Lancet. 1999 Apr 3;353(9159):1157
10209989
Otolaryngol Head Neck Surg. 2009 Jan;140(1):33-6
19130958
Stroke. 2000 Sep;31(9):2043-8
10978027
Dysphagia. 2006 Oct;21(4):243-53
17216386
BMC Neurosci. 2007 Aug 02;8:62
17678546
Gastroenterology. 1996 Aug;111(2):297-306
8690194
J Neurol Neurosurg Psychiatry. 1992 Sep;55(9):822-5
1402974
Am J Public Health. 2001 Jul;91(7):1121-3
11441742
Gastroenterology. 1999 Feb;116(2):455-78
9922328
Am J Physiol Gastrointest Liver Physiol. 2002 Jul;283(1):G16-26
12065287
Am J Gastroenterol. 2009 Oct;104(10):2431-8
19550414
Dysphagia. 2002 Spring;17(2):139-46
11956839
Arch Neurol. 1992 Dec;49(12):1259-61
1449405
Am J Gastroenterol. 1997 Jul;92(7):1194-6
9219798
Respir Care. 2001 May;46(5):466-74
11309186
AJR Am J Roentgenol. 1993 May;160(5):1005-9
8470567
J Biomech. 2001 Dec;34(12):1537-44
11716855
Ann Otol Rhinol Laryngol. 1991 Aug;100(8):678-81
1872520
J Neurophysiol. 1999 Apr;81(4):1917-26
10200226
Rev Esp Enferm Dig. 2004 Feb;96(2):119-31
15255021
Aliment Pharmacol Ther. 2006 Nov 1;24(9):1385-94
17059520
Dysphagia. 2001 Summer;16(3):190-5
11453566
Lancet. 1993 Feb 13;341(8842):432
8094188
J Am Geriatr Soc. 2006 Sep;54(9):1401-6
16970649
Dysphagia. 2001 Summer;16(3):168-70
11453561
Med Clin (Barc). 2005 May 21;124(19):742-8
15919036
J Am Geriatr Soc. 2003 Jul;51(7):1018-22
12834525
Gerontology. 2007;53(4):179-83
17264513
Gut. 1996 Jun;38(6):806-11
8984014
Dysphagia. 1997 Fall;12(4):177-9
9294935
BMC Neurosci. 2009 Jun 30;10:71
19566955
Mov Disord. 2005 Apr;20(4):457-62
15625689
Am J Respir Crit Care Med. 2001 Aug 1;164(3):464-8
11500351
Chest. 2003 Jul;124(1):328-36
12853541
Age Ageing. 1998 Mar;27(2):99-106
16296668
Otolaryngol Head Neck Surg. 2006 Nov;135(5):754-7
17071307
Gastroenterology. 2002 May;122(5):1314-21
11984518
Age Ageing. 2010 Jan;39(1):39-45
19561160
Dysphagia. 2001 Summer;16(3):216-9
11453570
Laryngoscope. 2002 Dec;112(12):2204-10
12461342
Cir Esp. 2007 Aug;82(2):62-76
17785140
J Am Geriatr Soc. 2008 Apr;56(4):661-6
18266664
Physiol Rev. 2001 Apr;81(2):929-69
11274347
Gastroenterology. 1997 Nov;113(5):1457-64
9352847
Am J Physiol. 1991 Sep;261(3 Pt 2):R639-46
1653542
Br Med J (Clin Res Ed). 1987 Aug 15;295(6595):411-4
3115478
Dysphagia. 2007 Jan;22(1):63-7
17024549
J Adv Nurs. 2009 Mar;65(3):477-93
19222645
J Am Geriatr Soc. 2002 May;50(5):975-6
12028196
Dysphagia. 1996 Summer;11(3):209-15
8755468
J Am Geriatr Soc. 2003 Apr;51(4):574-6
12657087
Ann Otol Rhinol Laryngol. 2009 Apr;118(4):241-6
19462842
J Am Geriatr Soc. 2004 Dec;52(12):2143-4
15571561
Dysphagia. 1996 Spring;11(2):93-8
8721066
Nutrition. 1999 Feb;15(2):116-22
9990575
J Am Geriatr Soc. 2005 Sep;53(9):1483-9
16137276
Folia Phoniatr Logop. 1995;47(3):140-64
7640720
J Am Geriatr Soc. 2005 May;53(5):824-8
15877558
Dysphagia. 1994 Winter;9(1):7-11
8131429
Stroke. 1999 Jun;30(6):1203-7
10356100
Int Nurs Rev. 2006 Jun;53(2):143-9
16650034
Acta Otolaryngol. 2009 May;129(5):560-8
18629672
Chest. 1998 May;113(5):1425
9596334
J Appl Physiol (1985). 2003 Jan;94(1):128-34
12486019
Med Clin (Barc). 2007 Sep 29;129(11):424-32
17927938
Neurogastroenterol Motil. 2003 Feb;15(1):69-77
12588471
J Speech Hear Res. 1995 Jun;38(3):556-63
7674647
Dysphagia. 2010 Mar;25(1):40-65
19760458
J Rehabil Res Dev. 2002 Jul-Aug;39(4):543-8
17638151
Lancet. 1998 Sep 26;352(9133):1069
9759784
Lancet. 2005 Feb 26-Mar 4;365(9461):755-63
15733716
Ann Intern Med. 2006 Jan 3;144(1):37-48
16389253
Arch Phys Med Rehabil. 1989 Oct;70(10):767-71
2802957