notificationsアラート設定
~
検索条件をクリア

アブストラクト

Title 4 サルコペニアと摂食嚥下障害 - 診断と治療 -
Subtitle 特集 摂食嚥下障害に対するリハビリテーション医学・医療 The Cutting Edge
Authors 藤島一郎*1, 國枝顕二郎*1,2
Authors (kana)
Organization *1浜松市リハビリテーション病院リハビリテーション科, *2岐阜大学大学院医学系研究科脳神経内科
Journal The Japanese Journal of Rehabilitation Medicine
Volume 59
Number 9
Page 888-896
Year/Month 2022 / 9
Article 報告
Publisher 日本リハビリテーション医学会
Abstract 「要旨」サルコペニアの診断は筋肉量の減少が必須であるとされたが, 2019年のEWGSOPの発表では筋肉量のみならず筋肉の質が大事であるとされている. 嚥下に関する筋肉は横紋筋であるが, 発生学的には鰓弓由来の呼吸筋に近く, 四肢の骨格筋とは別の特性をもっている. 安静時にも呼吸からのドライブがかかっているために廃用に陥りにくい. ただし, オトガイ舌骨筋のみは例外で, サルコペニアが生じやすい. 治療としては栄養管理と筋力強化が重要である. サルコペニアによる摂食嚥下障害の診断にはフローチャートが提案されているが, 確定診断は現時点では困難とされている. 嚥下筋の評価はエコーが有力視されている. 治療は運動と栄養療法が基本である.
Practice 医療技術
Keywords 嚥下筋, 老化, オトガイ舌骨筋, 嚥下筋力増強訓練, 栄養
  • 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
download全文ダウンロード(2.96MB)

参考文献

  • 1) Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA; Cardiovascular Health Study Collaborative Research Group: Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146-156
  • 2) 荒井秀典:フレイルの意義.日本老年医学会雑誌 2014;51:497-501
  • 3) Nakamura K: A "super-aged" society and the "locomotive syndrome". J Orthop Sci 2008;13:1-2
  • 4) Nishikawa H, Fukunishi S, Asai A, Yokohama K, Nishiguchi S, Higuchi K: Pathophysiology and mechanisms of primary sarcopenia (Review). Int J Mol Med 2021;48:156
    pubmed
  • 5) 鳥羽研二:老年症候群と総合的機能評価.日本内科学会誌 2009;98:589-594
残りの48件を表示する
  • 6) Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandewoude M, Zamboni M; European Working Group on Sarcopenia in Older People:Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39:412-423
  • 7) Fujishima I, Fujiu-Kurachi M, Arai H, Hyodo M, Kagaya H, Maeda K, Mori T, Nishioka S, Oshima F, Ogawa S, Ueda K, Umezaki T, Wakabayashi H, Yamawaki M, Yoshimura Y: Sarcopenia and dysphagia: Position paper by four professional organizations. Geriatr Gerontol Int 2019;19:91-97
  • 8) Rosenberg IH: Sarcopenia: origins and clinical relevance. J Nutr 1997;127(5 Suppl):990S-991S
  • 9) Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, Lee JS, Lee WJ, Lee Y, Liang CK, Limpawattana P, Lin CS, Peng LN, Satake S, Suzuki T, Won CW, Wu CH, Wu SN, Zhang T, Zeng P, Akishita M, Arai H: Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc 2014;15:95-101
  • 10) Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2: Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48:16-31
  • 11) Chen LK, Woo J, Assantachai P, Auyeung TW, Chou MY, Iijima K, Jang HC, Kang L, Kim M, Kim S, Kojima T, Kuzuya M, Lee JSW, Lee SY, Lee WJ, Lee Y, Liang CK, Lim JY, Lim WS, Peng LN, Sugimoto K, Tanaka T, Won CW, Yamada M, Zhang T, Akishita M, Arai H: Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc 2020;21:300-307
  • 12) サルコペニア診療ガイドライン作成委員会:サルコペニア診療ガイドライン2017年版.ライフサイエンス出版,東京, 2017;p 2
  • 13) Dhillon RJ, Hasni S: Pathogenesis and Management of Sarcopenia. Clin Geriatr Med 2017;33:17-26
  • 14) Roubenoff R, Hughes VA: Sarcopenia: current concepts. J Gerontol A Biol Sci Med Sci 2000;55:M716-724
  • 15) Bortz WM 2nd: The disuse syndrome. West J Med 1984;141:691-694
  • 16) Carmeli E, Coleman R, Reznick AZ: The biochemistry of aging muscle. Exp Gerontol 2002;37:477-489
  • 17) Kannus P, Jozsa L, Jarvinen TL, Kvist M, Vieno T, Jarvinen TA, Natri A, Jarvinen M: Free mobilization and low- to high-intensity exercise in immobilization-induced muscle atrophy. J Appl Physiol (1985) 1998;84:1418-1424
  • 18) Appell HJ: Morphology of immobilized skeletal muscle and the effects of a pre- and postimmobilization training program. Int J Sports Med 1986;7:6-12
  • 19) Seki K, Taniguchi Y, Narusawa M: Alterations in contractile properties of human skeletal muscle induced by joint immobilization. J Physiol 2001;530(Pt 3):521-532
  • 20) Seki K, Taniguchi Y, Narusawa M: Effects of joint immobilization on firing rate modulation of human motor units. J Physiol 2001;530(Pt 3):507-519
  • 21) Lexell J: Evidence for nervous system degeneration with advancing age. J Nutr 1997;127(5 Suppl):1011S-1013S
  • 22) Poggi P, Marchetti C, Scelsi R: Automatic morphometric analysis of skeletal muscle fibers in the aging man. Anat Rec 1987;217:30-34
  • 23) Gundersen K: Determination of muscle contractile properties: the importance of the nerve. Acta Physiol Scand 1998;162:333-341
  • 24) Brooks SV, Faulkner JA: Skeletal muscle weakness in old age: underlying mechanisms. Med Sci Sports Exerc 1994;26:432-439
  • 25) 新藤惠一郎:筋肉のアンチエイジングとリハビリテーション. Monthly Book Medical Rehabilitation 2010;124:21-25
  • 26) 藤島一郎,梅崎俊郎,杉山庸一郎:嚥下筋の特殊性とサルコペニア.嚥下医学 2020;9:7-11
  • 27) Grelot L, Barillot JC, Bianchi AL: Pharyngeal motoneurones: respiratory-related activity and responses to laryngeal afferents in the decerebrate cat. Exp Brain Res 1989;78:336-344
  • 28) Tangel DJ, Mezzanotte WS, White DP: Respiratory-related control of palatoglossus and levator palatini muscle activity. J Appl Physiol (1985) 1995;78:680-688
  • 29) Mathur R, Mortimore IL, Jan MA, Douglas NJ: Effect of breathing, pressure and posture on palatoglossal and genioglossal tone. Clin Sci (Lond) 1995;89:441-445
  • 30) Umezaki T, Shiba K, Zheng Y, Miller AD: Upper airway motor outputs during vomiting versus swallowing in the decerebrate cat. Brain Res 1998;781:25-36
  • 31) Kuna ST:Respiratory-related activation and mechanical effects of the pharyngeal constrictor muscles. Respir Physiol 2000;119:155-161
  • 32) Sherrey JH, Megirian D: Spontaneous and reflexly evoked laryngeal abductor and adductor muscle activity of cat. Exp Neurol 1974;43:487-498
  • 33) Sherrey JH, Megirian D: Analysis of the respiratory role of pharyngeal constrictor motoneurons of cat. Exp Neurol 1975;49:839-851
  • 34) Zoungrana OR, Amri M, Car A, Roman C: Intracellular activity of motoneurons of the rostral nucleus ambiguus during swallowing in sheep. J Neurophysiol 1997;77:909-922
  • 35) Sokoloff AJ, Douglas M, Rahnert JA, Burkholder T, Easley KA, Luo Q: Absence of morphological and molecular correlates of sarcopenia in the macaque tongue muscle styloglossus. Exp Gerontol 2016;84:40-48
  • 36) Feng X, Todd T, Lintzenich CR, Ding J, Carr JJ, Ge Y, Browne JD, Kritchevsky SB, Butler SG: Aging-related geniohyoid muscle atrophy is related to aspiration status in healthy older adults. J Gerontol A Biol Sci Med Sci 2013;68:853-860
  • 37) Mori T, Izumi S, Suzukamo Y, Okazaki T, Iketani S: Ultrasonography to detect age-related changes in swallowing muscles. Eur Geriatr Med 2019;10:753-760
  • 38) Rhee S, Yamamoto M, Kitamura K, Masaaki K, Katori Y, Murakami G, Abe SI: Macrophage density in pharyngeal and laryngeal muscles greatly exceeds that in other striated muscles: an immunohistochemical study using elderly human cadavers. Anat Cell Biol 2016;49:177-183
  • 39) Shaker R, Kern M, Bardan E, Taylor A, Stewart ET, Hoffmann RG, Arndorfer RC, Hofmann C, Bonnevier J: Augmentation of deglutitive upper esophageal sphincter opening in the elderly by exercise. Am J Physiol 1997;272(6 Pt 1):G1518-1522
  • 40) Antunes EB, Lunet N: Effects of the head lift exercise on the swallow function: a systematic review. Gerodontology 2012;29:247-257
  • 41) Komatsu R, Okazaki T, Ebihara S, Kobayashi M, Tsukita Y, Nihei M, Sugiura H, Niu K, Ebihara T, Ichinose M: Aspiration pneumonia induces muscle atrophy in the respiratory, skeletal, and swallowing systems. J Cachexia Sarcopenia Muscle 2018;9:643-653
  • 42) Wakabayashi H: Presbyphagia and Sarcopenic Dysphagia: Association between Aging, Sarcopenia, and Deglutition Disorders. J Frailty Aging 2014;3:97-103
  • 43) Shimizu A, Fujishima I, Maeda K, Murotani K, Ohno T, Nomoto A, Nagami S, Nagano A, Sato K, Ueshima J, Inoue T, Shimizu M, Ishida Y, Kayashita J, Suenaga M, Mori N: Delayed Dysphagia May Be Sarcopenic Dysphagia in Patients After Stroke. J Am Med Dir Assoc 2021;22:2527-2533
  • 44) Anker SD, Morley JE, von Haehling S: Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle 2016;7:512-514
  • 45) Mori T, Fujishima I, Wakabayashi H, Oshima F, Itoda M, Kunieda K, Kayashita J, Nishioka S, Sonoda A, Kuroda Y, Yamada M, Ogawa S: Development, reliability, and validity of a diagnostic algorithm for sarcopenic dysphagia. JCSM Clinical Reports 2017;2:1-10
  • 46) Ogawa N, Mori T, Fujishima I, Wakabayashi H, Itoda M, Kunieda K, Shigematsu T, Nishioka S, Tohara H, Yamada M, Ogawa S: Ultrasonography to Measure Swallowing Muscle Mass and Quality in Older Patients With Sarcopenic Dysphagia. J Am Med Dir Assoc 2018;19:516-522
  • 47) Ogawa N, Wakabayashi H, Mori T, Fujishima I, Oshima F, Itoda M, Kunieda K, Shigematsu T, Nishioka S, Tohara H, Ohno T, Nomoto A, Shimizu A, Yamada M, Ogawa S: Digastric muscle mass and intensity in older patients with sarcopenic dysphagia by ultrasonography. Geriatr Gerontol Int 2021;21:14-19
  • 48) Kunieda K, Fujishima I, Wakabayashi H, Ohno T, Shigematsu T, Itoda M, Oshima F, Mori T, Ogawa N, Ogawa S: Relationship Between Tongue Pressure and Pharyngeal Function Assessed Using High-Resolution Manometry in Older Dysphagia Patients with Sarcopenia: A Pilot Study. Dysphagia 2021;36:33-40
  • 49) Nativ-Zeltzer N, Logemann JA, Zecker SG, Kahrilas PJ: Pressure topography metrics for high-resolution pharyngeal-esophageal manofluorography-a normative study of younger and older adults. Neurogastroenterol Motil 2016;28:721-731
  • 50) 西岡心大:栄養管理について-予防・治療の視点も含めて.嚥下医学 2020;9:19-24
  • 51) 森隆志:嚥下筋の訓練法-予防・治療の視点も含めて.嚥下医学 2020;9:37-41
  • 52) 前田圭介:嚥下障害を持つ患者の栄養療法.レジデントノート 2018;20:2063-2070
  • 53) Kagaya H, Inamoto Y: Possible Rehabilitation Procedures to Treat Sarcopenic Dysphagia. Nutrients 2022;14:778
    pubmed
はじめての方へ
個人／法人会員登録のご案内