title: Detecting signs of dysphagia in patients with Alzheimer's disease with oral feeding in daily life.
abstract: OBJECTIVE
  It is important to understand dysphagia in patients with dementia, as it is associated with malnutrition and aspiration pneumonia. Particularly in patients with Alzheimer's disease (AD), mortality from pneumonia is high and accounts for 70% of the causes of death. However, the standard swallowing tests are often difficult to use for patients with dementia, and methods to assess daily swallowing function are required. Therefore, the purpose of the present study was to identify signs of dysphagia in AD patients in daily life.
  
  
  METHODS
  A total of 155 AD patients underwent evaluation of their swallowing function (modified water swallowing test), oral status (residual teeth, occlusal contacts), oral functions (lips function, tongue function, rinsing and gargling ability), vital functions (Barthel Index, Vitality Index), nutritional status (serum albumin, body mass index), cognitive function and neurological signs (Mini-Mental State Examination, Clinical Dementia Rating, limb contractures), and diet-related assessments (storing food in the mouth, stuffing food into the mouth, appetite, caloric intake).
  
  
  RESULTS
  The severity of AD was significantly associated with swallowing function (P < 0.001). According to logistic regression analysis, the factor most significantly associated with dysphagia was "rinsing ability" (P = 0.001, odds ratio 4.8, 95% confidence interval 1.9-12.1).
  
  
  CONCLUSIONS
  The factors that affect swallowing function in AD patients were examined. The swallowing function of severe AD patients was poor, and an association between AD and dysphagia was shown. Defective rinsing ability was identified as a risk factor for dysphagia. Therefore, observation of daily rinsing ability appears to be useful to identify signs of dysphagia in AD patients.
authors.affiliation: Oral Medicine and Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba, Japan.
authors.forename: Emiko
authors.initials: E
authors.lastname: Sato
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Hirano
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Ayako
authors.initials: A
authors.lastname: Edahiro
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Sato
authors.forename: Genyuki
authors.initials: G
authors.lastname: Yamane
authors.forename: Akira
authors.initials: A
authors.lastname: Katakura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Alzheimer's disease; dementia; dysphagia; modified water swallowing test; rinsing ability