Predictive Factors for Swallowing Function Decline in Older Adults With Alzheimer's Disease: A 1-Year Longitudinal Study.

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of oral rehabilitation Pub Date : 2024-11-26 DOI:10.1111/joor.13912

Maki Shirobe, Ayako Edahiro, Keiko Motokawa, Shiho Morishita, Yuki Ohara, Yutaka Watanabe, Masanori Iwasaki, Hirohiko Hirano

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Abstract

Background: By 2060, the global burden of dementia, particularly Alzheimer's disease (AD), is expected to increase significantly, necessitating effective palliative care strategies. Dysphagia, a common condition among people with dementia, leads to malnutrition, aspiration pneumonia, and a reduced quality of life.

Objective: This study aimed to identify oral health management factors that could predict a decline in swallowing function in older adults with AD.

Methods: Data from the Akita-Omorimachi study, which included 63 adults diagnosed with AD, were analysed. Swallowing function was assessed using the modified water-swallowing test (MWST) at baseline and after 1 year.

Results: The results indicated that 25.4% of participants exhibited a decline in swallowing function, as indicated by a decrease from the highest MWST score of 5 at baseline to a lower score at follow-up. Poisson regression analysis revealed that refusal of oral care (incidence rate ratio (IRR): 7.28), tongue coating (IRR: 4.21), and unclear articulation of /ka/ (IRR: 5.79) were significant predictors of swallowing function decline. The participants with these indicators had a higher risk of developing dysphagia.

Conclusions: These findings suggest that factors related to specific oral health problems may predict poor swallowing function in older adults with AD. Moreover, implementing targeted oral care interventions, including person-centered care and regular tongue cleaning, may improve the outcomes in this vulnerable population. Despite the limitations of this study, including a small sample size, the results underscore the importance of comprehensive oral health management in preventing dysphagia-related complications.

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老年痴呆症患者吞咽功能下降的预测因素：为期一年的纵向研究

背景：到 2060 年，全球痴呆症，尤其是阿尔茨海默病（AD）的发病率预计将大幅增加，因此有必要采取有效的姑息治疗策略。吞咽困难是痴呆症患者的常见病，会导致营养不良、吸入性肺炎和生活质量下降：本研究旨在确定可预测老年痴呆症患者吞咽功能下降的口腔健康管理因素：方法：分析了秋田-大森町研究的数据，该研究包括 63 名被诊断为 AD 的成年人。采用改良吞咽水试验（MWST）对基线和一年后的吞咽功能进行评估：结果表明，25.4%的参与者表现出吞咽功能下降，表现为从基线时最高的MWST得分5分下降到随访时的较低分数。泊松回归分析显示，拒绝口腔护理（发生率比 (IRR)：7.28）、舌苔（IRR：4.21）和/ka/发音不清（IRR：5.79）是吞咽功能下降的重要预测指标。有这些指标的参与者出现吞咽困难的风险更高：这些研究结果表明，与特定口腔健康问题相关的因素可能预示着患有 AD 的老年人吞咽功能较差。此外，实施有针对性的口腔护理干预措施，包括以人为本的护理和定期清洁舌头，可能会改善这一弱势群体的治疗效果。尽管这项研究存在样本量小等局限性，但研究结果强调了全面口腔健康管理对预防吞咽困难相关并发症的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.