Clinical determinants and neural correlates of presbyphagia in community-dwelling older adults

Labeit, Bendix; Muhle, Paul; Itter, Jonas von; Slavik, Janna; Wollbrink, Andreas; Sporns, Peter; Rusche, Thilo; Ruck, Tobias; Hüsing‐Kabar, Anna; Gellner, Reinhold; Groß, Joachim; Wirth, Rainer; Claus, Inga; Warnecke, Tobias; Dziewas, Rainer; Suntrup‐Krueger, Sonja

doi:10.3389/fnagi.2022.912691

Cited by 19 publications

(14 citation statements)

References 85 publications

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“…In terms of swallowing safety, a larger product could increase sensory perception, thus enhancing sensorimotor feedback as a compensatory mechanism. This is supported by previous clinical studies that have shown that intact pharyngeal sensation is important for a physiological swallowing process 28 , 29 . The findings on medication size contrast with a Food and Drug Administration (FDA) guidance document that considers the size of tablets or capsules to be a possible risk factor for dysphagia for medication and therefore recommends the production of small products.…”

Section: Discussionsupporting

confidence: 85%

Dysphagia for medication in Parkinson’s disease

Labeit

Berkovich²,

Claus

et al. 2022

npj Parkinsons Dis.

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Dysphagia is common in Parkinson’s disease (PD) and is assumed to complicate medication intake. This study comprehensively investigates dysphagia for medication and its association with motor complications in PD. Based on a retrospective analysis, a two-dimensional and graduated classification of dysphagia for medication was introduced differentiating swallowing efficiency and swallowing safety. In a subsequent prospective study, sixty-six PD patients underwent flexible endoscopic evaluation of swallowing, which included the swallowing of 2 tablets and capsules of different sizes. Dysphagia for medication was present in nearly 70% of PD patients and predicted motor complications according to the MDS-UPDRS-part-IV in a linear regression model. Capsules tended to be swallowed more efficiently compared to tablets, irrespective of size. A score of ≥1 on the swallow-related-MDS-UPDRS-items can be considered an optimal cut-off to predict dysphagia for medication. Swallowing impairment for oral medication may predispose to motor complications.

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Section: Discussionsupporting

confidence: 85%

Dysphagia for medication in Parkinson’s disease

Labeit

Berkovich²,

Claus

et al. 2022

npj Parkinsons Dis.

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“…Swallowing impairment is common in most neurological disorders such as stroke, Parkinson's disease, dementia, neuroinflammatory diseases, and neuromuscular disorders, but can also occur in healthy older people. [1][2][3][4][5][6][7][8][9][10] Often, the oral and pharyngeal phases of swallowing are affected simultaneously, which is characterized as oropharyngeal dysphagia.…”

Section: Introductionmentioning

confidence: 99%

Costs of post-stroke dysphagia during acute hospitalization from a health-insurance perspective

Labeit

Kremer

Muhle

et al. 2022

European Stroke Journal

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Purpose: Oropharyngeal dysphagia is a common and complication-prone symptom after stroke and is assumed to increase medical expenses. The purpose of this study was therefore to examine acute hospitalization costs associated with post-stroke dysphagia. Method: This retrospective study included patients with acute stroke who had been examined by Flexible Endoscopic Evaluation of Swallowing (FEES). Health insurance expenditures were determined for the patient cases according to the 2021 revenue criteria. Multiple linear regression was used to examine predictors of health insurance spending including age, sex, stroke severity, stroke characteristics, comorbidity, therapeutic interventions, duration of artificial ventilation, length of hospital stay, and severity of dysphagia, as assessed by the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), ranging from 1 (best) to 6 (worst). Findings: Six hundred seventy four patients (men/women: 367/307; mean age: 71.1 ± 12.8 years; mean National Institute of Health Stroke Scale: 11.2 ± 6.2; FEDSS 1/2/3/4/5/6: 113/73/144/119/124/101; mean health-insurance costs 11,521.5 ± 12,950.5€) were included in the analysis. Advanced age ( p = 0.007; B = 57.6), catheter interventions ( p < 0.001; B = 4105.6), tracheotomy ( p = 0.006; B = 5195.2), duration of artificial ventilation ( p < 0.001; B = 388.6), length of hospital stay ( p < 0.001; B = 441.9), and severe dysphagia with an FEDSS of 6 ( p = 0.004, B = 2554.3) were independent predictors of increased health insurance expenditures ( p < 0.001, R-squared = adjusted-R-squared = 0.83). Discussion and conclusion: The results of this study show an association between severe dysphagia and health care costs for acute hospitalization from a health-insurance perspective. Therefore, therapies that target severe dysphagia with impaired secretion management may have the potential to reduce costs.

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“…With aging, many changes are involved, such as reduced muscle mass, lower saliva production, reduced sense of taste and smell [ 1 – 3 ], and less coordination between swallowing and respiratory functions [ 4 ]. These age-related physiological changes in the swallowing mechanism correspond to presbyphagia and are not considered pathological [ 5 ]. Presbyphagia can be responsible for changes in eating habits, with the implementation of compensatory strategies by the elderly, such as reducing the quantities ingested [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Acoustic Analysis of Swallowing of an Experimental Meal of Three Food Textures: A Comparative Aging Study

Baqué,

Huret,

Rayneau

et al. 2023

Dysphagia

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Swallowing disorders in the elderly represent a public health problem, their detections are a medico-economic issue. The acoustic analysis of swallowing has the advantages of being non-invasive with no radiation, compared to videofluoroscopy or fiberoptic swallowing assessments. Acoustic analysis of swallowing has been tested in many studies but only on small food boluses. The aim of this study was to compare the acoustic swallowing parameters of two groups of healthy subjects, before and after 70 years old, during the intake of a series of 3 food textures. A laryngophone was used to record the pharyngeal phase of swallowing. The experimental meal was composed of 100 ml of mashed potatoes, 100 ml of water, and 100 ml of yogurt. Group 1 (50–70 years old) comprised 21 subjects and group 2 (over 70 years old) 23 subjects. Acoustic parameters analyzed were the number of swallows, average duration of swallowing, average duration of inter-swallowing, meal duration, and the average frequency of swallowing per minute. These parameters for groups 1 and 2 were compared. The average duration of inter-swallowing and the meal duration were significantly higher in the older group (p < 0.001), with a mean duration of inter-swallowing that was 2.4 s longer than the younger group. The average swallowing frequency per minute was higher in the younger group (11.3 vs 7.9; p < 0.001). This study demonstrated that acoustic analysis of an experimental meal of three food textures generated usable data on swallowing. In the over 70 age group, there was a decrease in swallowing frequency, indicating a slowdown in food intake. A reduced swallowing frequency could become a criteria to assess presbyphagia.

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Clinical determinants and neural correlates of presbyphagia in community-dwelling older adults

Cited by 19 publications

References 85 publications

Dysphagia for medication in Parkinson’s disease

Dysphagia for medication in Parkinson’s disease

Costs of post-stroke dysphagia during acute hospitalization from a health-insurance perspective

Acoustic Analysis of Swallowing of an Experimental Meal of Three Food Textures: A Comparative Aging Study

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