Japanese

Title	老嚥が疑われる高齢者の特徴〜サルコペニア・嚥下関連筋のサルコペニア・口腔機能・栄養状態との関連〜
Subtitle	短報
Authors	松原慶吾1), 水本豪2), 古賀和美3), 池嵜寛人1), 平江満充帆1), 兒玉成博1), 畑添涼1), 小薗真知子1), 元田真一4)
Authors (kana)
Organization	1)熊本保健科学大学保健科学部リハビリテーション学科言語聴覚学専攻, 2)熊本保健科学大学保健科学部共通教育センター, 3)熊本保健科学大学保健科学部医学検査学科, 4)ケアサポートメロン
Journal	日本摂食嚥下リハビリテーション学会雑誌
Volume	27
Number	1
Page	53-60
Year/Month	2023 / 4
Article	報告
Publisher	日本摂食嚥下リハビリテーション学会
Abstract	「要旨」【目的】健常高齢者における摂食嚥下機能のフレイルは老人性嚥下機能低下 (以下, 老嚥) と呼ばれる. 摂食嚥下器官の加齢変化には性差があることから, 老嚥の特徴は男女間で異なることが予想される. 本研究では, 地域在住高齢者を対象に, 老嚥が疑われる高齢者と嚥下機能が良好な高齢者の症状およびサルコペニア・嚥下関連筋のサルコペニア・口腔機能・栄養状態の比較を行い, 老嚥の特徴を男女別に検討した. 【方法】地域に在住する高齢者64例を対象とした. 摂食嚥下機能の評価にはEating Assessment Tool-10 (以下, EAT-10) を用い, 嚥下機能良好群と老嚥が疑われた老嚥群に分けた. サルコペニアの評価には, 骨格筋指数, 握力, 最大歩行速度を測定し, 嚥下関連筋のサルコペニアの評価には, オトガイ舌骨筋の筋量, 最大舌圧を測定した. さらに, 口腔機能は基本チェックリストを用い, 栄養状態はMNA(R)-SFを用いて調査した. 男女別に2群間のサルコペニア, 嚥下関連筋のサルコペニア, 口腔機能, 栄養状態について比較検討した. 【結果】解析対象は, 61例 (78.6±7.3歳, 男性16例, 女性45例) とし, 高齢者の23.0%に老嚥が疑われた. 男性老嚥群は嚥下機能良好群と比べて, EAT-10の「食べる時に咳が出る」で有意差を認め, 低骨格筋量と低舌圧の有無の割合, 最大歩行速度, オトガイ舌骨筋の筋量に有意差を認めた. 女性老嚥群は嚥下機能良好群と比べて, EAT-10の「飲み込みの問題が原因で体重が減少した」, 「食べる時に咳が出る」の2つの質問項目で有意差を認めた. また, 口腔機能, 口腔乾燥, MNA(R)-SFの体重減少で有意差を認めた. 【結論】高齢者の23.0%に老嚥が疑われた. 老嚥の疑われる高齢者にみられる症状は男女ともに「食事中の咳の増加」であった. しかし, それを引き起こしている摂食嚥下機能の低下の機序は男女間で異なる可能性が示唆された.
Practice	医療技術
Keywords	老嚥, 性差, サルコペニア, 口腔機能, 栄養状態, presbyphagia, gender, sarcopenia, oral function, nutritional status

English

Title	Characteristics of Elderly Suspected of Presbyphagia : Relationship between Sarcopenia, Sarcopenia of Swallowing-Related Muscles, Oral Function, and Nutritional Status
Subtitle
Authors	Keigo MATSUBARA1), Go MIZUMOTO2), Kazumi KOGA3), Hiroto IKEZAKI1), Mamiho HIRAE1), Narihiro KODAMA1), Ryo HATAZOE1), Machiko KOZONO1), Shinichi MOTODA4)
Authors (kana)
Organization	1)Division of Speech-Language-Hearing Therapy, Department of Rehabilitation, Faculty of Health Science, Kumamoto Health Science University, 2)Center for General Education, Faculty of Health Science, Kumamoto Health Science University, 3)Department of Medical Technology, Faculty of Health Science, Kumamoto Health Science University, 4)Care Support Melon
Journal	The Japanese Journal of Dysphagia Rehabilitation
Volume	27
Number	1
Page	53-60
Year/Month	2023 / 4
Article	Report
Publisher	The Japanese Society of Dysphagia Rehabilitation
Abstract	[Abstract] [Objective] : Impaired eating and swallowing function in healthy elderly people is called presbyphagia. Because there are gender differences in age-related changes to the feeding and swallowing organs, the characteristics of presbyphagia are expected to differ between men and women. Therefore, we compared the symptoms - sarcopenia, sarcopenia of swallowing-related muscles, oral function, and nutritional status - of community-dwelling elderly with suspected presbyphagia and those with good swallowing function and examined the different characteristics of presbyphagia in men and women. [Methods] : Sixty-four community-dwelling elderly were included in this study. The Eating Assessment Tool-10 (EAT-10) was used to assess eating and swallowing function, and the elderly were divided into two groups : one with good swallowing function and one with suspected presbyphagia. Skeletal muscle index, grip strength, and maximum walking speed were measured to assess sarcopenia, and muscle mass of the geniohyoid muscle and maximum tongue pressure were measured to assess sarcopenia of swallowing-related muscles. Oral function was assessed using a basic checklist, and nutritional status was determined using the MNA(R)-SF. Sarcopenia, sarcopenia of swallowing-related muscles, oral function, and nutritional status were compared between men and women. [Results] : Sixty-one subjects were analyzed (78.6 +- 7.3 years old, 16 males, 45 females). Presbyphagia was suspected in 23.0% of the community-dwelling elderly. Compared to the group with good swallowing function, the male presbyphagia group showed significant differences in the EAT-10 measurement "coughing when eating," the percentage of low skeletal muscle mass and low tongue pressure, maximum walking speed, and the muscle mass of the geniohyoid muscle. In contrast, compared to the group with good swallowing function, the female presbyphagia group showed significant differences in two EAT-10 measurements : "weight loss due to swallowing problems" and "coughing when eating." This group also showed significant differences in oral function and xerostomia on the basic checklist and weight loss on the MNA(R)-SF. [Conclusion] : Presbyphagia was suspected in 23.0% of the elderly. Symptoms of suspected presbyphagia were "increased coughing while eating" in both men and women. However, the mechanism of the decline in feeding and swallowing function that causes the symptoms may differ between men and women.
Practice	Medical technology
Keywords	presbyphagia, gender, sarcopenia, oral function, nutritional status

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