Oropharyngeal dysphagia in elderly population suffering from mild cognitive impairment and mild dementia: Understanding the link

吞咽困难 医学 吞咽 痴呆 口咽吞咽困难 人口 儿科 认知 物理疗法 内科学 精神科 外科 疾病 环境卫生
作者
Alessandro De Stefano,Pamela Di Giovanni,Gautham Kulamarva,Susanna Gennachi,Francesca Di Fonzo,Vincenzo Sallustio,Danilo Patrocinio,Serena Candido,Giuseppina Lamarca,Francesco Dispenza
出处
期刊:American Journal of Otolaryngology [Elsevier BV]
卷期号:41 (4): 102501-102501 被引量:14
标识
DOI:10.1016/j.amjoto.2020.102501
摘要

To evaluate the prevalence of oropharyngeal dysphagia in elderly patients suffering from minimal or mild cognitive decline. We retrospectively collected the data of patients suffering from mild cognitive impairment or mild dementia and were undergoing management for suspected oropharyngeal dysphagia, in our department. All our patients were subjected to Mini Mental State Examination test, MD Anderson dysphagia inventory and caregiver mealtime and dysphagia questionnaire. We performed a mealtime observation study and endoscopic evaluation of swallowing in all our patients. Following evaluation, we then analysed the data statistically. Out of 708 patients who visited us for cognitive decline and suspected oropharyngeal dysphagia in the last two years, 52 patients were confirming to the inclusion criteria of this study. Classification of oropharyngeal dysphagia patients according to ASHA-NOMS scale showed that 32.7% of patients presented with grade 4 of dysphagia followed by another 32.7% with grade 5 and 30.8% presented with grade 6. Only 3.8% of our patients were considered normal (grade 7 of ASHA-NOMS scale). MD Anderson dysphagia inventory could collected swallowing alterations in only 23.1% of the cases. The caregiver mealtime and dysphagia questionnaire showed acceptable caregivers patient management in 53.8% of patients. Our study underscores the fact that oropharyngeal dysphagia is present in many cases of mild cognitive decline. While patients understate their swallowing problems, the caregivers are not competent enough to manage this situation in a great percentage of cases. Only a mealtime observation by a speech-language pathologist along with FEES is able to identify the true prevalence of the condition.
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