Yaşlılarda Yutma Fonksiyonu ve Ağız Bakımı

Year 2022, , 21 - 27, 30.04.2022

Rukiye Demir Dikmen

https://doi.org/10.47141/geriatrik.1050021

Abstract

Dünyada yaşlı birey sayısının artacağı öngörülmektedir. Yaşlanma ile beraber birçok sağlık sorunu ortaya çıkmaktadır. Yaşlılarda görülen disfaji bu sorunlardan biridir. Yaşlılar disfajiyi, yiyeceğin boğaza ve göğüse yapıştığı hissi ile ifade etmektedirler. Disfaji bir hastalık olmamakla beraber çeşitli tıbbi durumlardan kaynaklanmaktadır. Yaşlılarda, sarkopeni, etkisiz çiğneme, tükrük salgısında azalma gibi nedenler disfajiye sebep olabilmektedir. Disfaji ise sıklıkla yetersiz beslenme, aspirasyon pnömonisi, morbidite ve mortaliteye yol açabilmektedir. Disfaji yaşayan yaşlılar yeterli ağız bakımına ihtiyaç duymaktadırlar. Kaliteli bir ağız bakımının gıda alımını kolaylaştırdığı bilinmektedir. Ağız bakımı, ağız kuruluğunu giderebilir ve tükürük salgısını arttırarak iştahı artırabilir. Disfajisi olan yaşlılarda ağız bakımı önemlidir.

Keywords

yaşlı, yutma fonksiyonu, disfaji, ağız bakımı

Swallowing Function and Oral Care in Older Adults

Abstract

It is predicted that the number of older adults in the world will increase. Many health problems arise with aging. Dysphagia in the elderly is one of these problems. The older adults express dysphagia as the feeling of food sticking to the throat and chest. Reasons such as sarcopenia, ineffective chewing, and decreased salivation may cause dysphagia in the elderly. On the other side, dysphagia frequently leads to malnutrition, aspiration pneumonia, morbidity, and mortality. Dysphagia is not a disease but is caused by various medical conditions. Older adults with dysphagia need oral care. It is known that quality oral care facilitates food intake. Oral care can relieve dry mouth and increase appetite by increasing salivation. Oral care is essential for older adults with dysphagia.

Keywords

older people, swallowing function, dysphagia, care

References

• 1. Jacobsen FF. Active ageing. Int Pract Dev J. 2017; 7 Suppl: 1–13.
• 2. Robbins J, Hamilton JW, Lof GL, et al. Oropharyngeal swallowing in normal adults of different ages. Gastroenterology. 1992 Sep; 103(3):823-9.
• 3. Rofes L, Arreola V, Romea M, et al. Pathophysiology of oropharyngeal dysphagia in the frail elderly. Neurogastroenterol Motil. 2010; 22: 851–e230.
• 4. Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet. 2013; 381: 752–762.
• 5. Minakuchi S, Tsuga K, Ikebe K, et al. Oral hypofunction in the older population: Position paper of the Japanese Society of Gerodontology in 2016. Gerodontology. 2018; 35: 317–324.
• 6. Sura L, Madhavan A, Carnaby G, et al. Dysphagia in the elderly: Management and nutritional considerations. Clin. Interv. Aging. 2012;7:287–298.
• 7. Madhavan A, LaGorio LA, Crary MA, et al. Prevalence of and Risk Factors for Dysphagia in the Community Dwelling Elderly: A Systematic Review. J. Nutr. Health Aging. 2016;20:806–815.
• 8. Eslick GD, Talley NJ. Dysphagia: Epidemiology, risk factors and impact on quality of life—A population-based study. Aliment. Pharmacol. Ther. 2008;27:971–979.
• 9. Maeda K., Akagi J. Decreased tongue pressure is associated with sarcopenia and sarcopenic dysphagia in the elderly. Dysphagia. 2015;30:80–87.
• 10. Ohara Y, Yoshida N, Kono Y, et al. Effectiveness of an oral health educational program on community-dwelling older people with xerostomia. Geriatr. Gerontol. Int. 2015;15:481–489.
• 11. Jean A. Brain stem control of swallowing: Neuronal network and cellular mechanisms. Physiol. Rev. 2001;81:929–969.
• 12. Peyron MA, Woda A, Bourdiol P, et al. Age-related changes in mastication. J. Oral Rehabil. 2017;44:299–312.
• 13. Kugimiya Y., Watanabe Y., Igarashi K., et al. Factors associated with masticatory performance in community-dwelling older adults: A cross-sectional study. J. Am. Dent. Assoc. 2020;151:118–126.
• 14. Maruyama M, Morita K, Kimura H, et al. Association between masticatory ability and oral functions. J. Clin. Exp. Dent. 2020;2:e1011–e1014.
• 15. Sasegbon A, Hamdy S. The anatomy and physiology of normal and abnormal swallowing in oropharyngeal dysphagia. Neurogastroenterol. Motil. 2017;29(11):10.1111/nmo.13100.
• 16. Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015;12(5):259-270.
• 17. Patel DA, Krishnaswami S, Steger E, et al. Economic and survival burden of dysphagia among inpatients in the United States. Dis Esophagus. 2018;31(1):1-7.
• 18. Thiyagalingam S, Kulinski AE, Thorsteinsdottir B, et al. Dysphagia in Older Adults. Mayo Clinic proceedings. 2021; 96(2), 488–497.
• 19. Christmas C, Rogus-Pulia N. Swallowing Disorders in the Older Population. Journal of the American Geriatrics Society. 2019; 67(12), 2643–2649.
• 20. Baijens LW, Clavé P, Cras P, al. European Society for Swallowing Disorders - European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016;11:1403–28.
• 21. Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: Incidence, diagnosis, and pulmonary complications. Stroke. 2005;36:2756–2763.
• 22. Rofes L, Arreola V, Almirall J, et al. Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract. 2011; 2011:818979.
• 23. McCoy YM, Desai RV. Presbyphagia versus dysphagia: identifyng age-related changes in swallow function. Perspective ASHA Spec Interest Groups. 2018;3(15):15-21.
• 24. Barrera MA, O’Connor Wells B. Presbyphagia versus dysphagia: normal versus abnormal swallowing symptoms in older adults with parkinson disease and multiple sclerosis. Top Geriatr Rehabil. 2019;35(3):217-233.
• 25. Buehring B, Hind J, Fidler E,et al. Tongue strength is associated with jumping mechanography performance and handgrip strength but not with classic functional tests in older adults. J Am Geriatr Soc. 2013. March;61(3):418–22.
• 26. Molfenter SM, Lenell C, Lazarus CL. Volumetric Changes to the Pharynx in Healthy Aging: Consequence for Pharyngeal Swallow Mechanics and Function. Dysphagia. 2019. 02;34(1):129–37.
• 27. Groher ME, Crary MA. Dysphagia in Adults. Dysphagia: Ed.: Wurm-Cutter, E. Clinical Management in Adults and Children, Third Edition, Printed in The United States of America, Mosby Elsevier, 2010,43.
• 28. Sakai K, Nakayama E, Tohara H, et al. Relationship between tongue strength, lip strength, and nutrition-related sarcopenia in older rehabilitation inpatients: a cross-sectional study. Clin Interv Aging. 2017;12:1207–14.
• 29. Morita K, Tsuka H, Kato K, et al. Factors related to masticatory performance in healthy elderly individuals. J Prosthodont Res. 2018. October;62(4):432–5.
• 30. Affoo RH, Foley N, Garrick R, et al. Meta-Analysis of Salivary Flow Rates in Young and Older Adults. J Am Geriatr Soc. 2015. October;63(10):2142–51.
• 31. Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008 Dec; 117(12):919-24.
• 32. Rommel N, Hamdy S. Oropharyngeal dysphagia: manifestations and diagnosis. Nat Rev Gastroenterol Hepatol. 2016 Jan; 13(1):49-59.
• 33. Triggs, J., & Pandolfino, J. (2019). Recent advances in dysphagia management. F1000Research, 8, F1000 Faculty Rev-1527.
• 34. Omari TI, Dejaeger E, Van Beckevoort D, Goeleven A, De Cock P, Hoffman I, Smet MH, Davidson GP, Tack J, Rommel N. A novel method for the nonradiological assessment of ineffective swallowing. Am J Gastroenterol. 2011 Oct; 106(10):1796-802.
• 35. Carlson DA. Functional lumen imaging probe: The FLIP side of esophageal disease. Curr Opin Gastroenterol. 2016 Jul; 32(4):310-8.)
• 36. Hu H.H. Taiwan Guidelines for the Management of Stroke.Page:8-40. http//www.stroke.org.tw/GoWeb2/include/pdf/08%20. Erişim tarihi: 26 Aralık 2021
• 37. Humbert IA, Robbins J. Dysphagia in the elderly. Phys Med Rehabil Clin N Am. 2008;19(4):853-866.18
• 38. Tagliaferri S, Lauretani F, Pelá G, et al. The risk of dysphagia is associated with malnutrition and poor functional outcomes in a large population of outpatient older individuals. Clin Nutr. 2019;38(6):2684-2689.
• 39. Namasivayam-MacDonald AM, Shune SE. The burden of dysphagia on family caregiver of the elderly: a systematic review. Geriatrics. 2018;3(2):30.
• 40. Lieber AC, Hong E, Putrino D. Nutrition, energy expenditure, dysphagia, and self-fficacy in stroke rehabilitation: A review of the literature. Brain Sci. 2018;8:218.
• 41. Salamone K, Yacoub E, Mahoney AM, et al. Oral care of hospitalised older patients in the acute medical setting. Nurs. Res. Pract. 2013;2013:827670.
• 42. Dodds M, Roland S, Edgar M, et al. Saliva A review of its role in maintaining oral health and preventing dental disease. BDJ Team. 2015;2:15123.
• 43. Severo Alves L, Dam-Teixeira N, Susin C, et al. Association among quality of life, dental caries treatment and intraoral distribution in 12-year-old South Brazilian schoolchildren. Community Dent. Oral Epidemiol. 2013;41:22–29.
• 44. Abanto J, Paiva SM, Sheiham A, et al. Changes in preschool children’s OHRQoL after treatment of dental caries: Responsiveness of the B-ECOHIS. Int. J. Paediatr. Dent. 2016;26:259–265.
• 45. Samnieng P, Ueno M, Shinada K, et al. Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai. Community Dent. Health. 2012;29:117–123.
• 46. Lam OL, McMillan AS, Samaranayake LP, et al. Randomized clinical trial of oral health promotion interventions among patients following stroke. Arch. Phys. Med. Rehabi. 2013;94:435–443.
• 47. Chipps E, Gatens C, Genter L, et al. Pilot study of an oral care protocol on poststroke survivors. Rehabil. Nurs. 2014;39:294–304.
• 48. Toniolo L, Cancellara P, Maccatrozzo L, et al. Masticatory myosin unveiled: First determination of contractile parameters of muscle fibers from carnivore jaw muscles. Am. J. Physiol. Cell Physiol. 2008;295:1535–1542.
• 49. Sumi Y. The significance of oral care in dysphagia patients. Nihon Ronen Igakkai Zasshi. 2013;50:465–468.
• 50. Liu CL, Lin FY, Hwu YJ. The effectiveness of a complex care program on oral hygiene in a population of chronic psychiatric patients. J. Nurs. Healthc. Res. 2014;10:286–294.
• 51. Kuo YW, Yen M, Fetzer S, et al. Effect of family caregiver oral care training on stroke survivor oral and respiratory health in Taiwan: A randomised controlled trial. Community Dent. Health. 2015;32:137–142.
• 52. Makino T, Yamasaki M, Fujii N, et al. Perioperative oral management for esophageal cancer patients. Kyobu Geka Jpn. J. Thorac. Surg. 2016;69:35–39.
• 53. Barbe AG, Bock N, Derman SH, et al. Self-assessment of oral health, dental health care and oral health-related quality of life among Parkinson’s disease patients. Gerodontology. 2017;34:135–143.
• 54. Seedat J., Penn C. Implementing oral care to reduce aspiration pneumonia amongst patients with dysphagia in a South African setting. S. Afr. J. Commun. Disord. 2016;63:1–11.
• 55. Sorensen RT, Rasmussen RS, Overgaard K, et al. Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J. Neurosci. Nurs. 2013;45:139–146.
• 56. Huang WY. Drug induced oral reactions in elderly individuals of long-term care facility. J. Long-Term Care. 2015;19:1–12.
• 57. Chen, HJ, Chen JL, Chen CY, et al. Effect of an Oral Health Programme on Oral Health, Oral Intake, and Nutrition in Patients with Stroke and Dysphagia in Taiwan: A Randomised Controlled Trial. International journal of environmental research and public health. 2019; 16(12), 2228.
• 58. McCullough GH, Rosenbek JC, Wertz RT, et al. Defining swallowing function by age: Promises and pitfalls of pigeonholing. Top Geriatr Rehabil. 2007; 4: 290–307.
• 59. Akhtar S. Diseases of aging. In: Hines RL, Marschall KE, eds. Stoelting’s Anesthesia and Co-Existing Disease. 7th ed. Elsevier; 2017:327-343.
• 60. Lim M. Basic oral care for patients with dysphagia - A Special Needs Dentistry perspective. 2018; 20 (3): 142-149.