Triad of rehabilitation, nutrition, and oral management for sarcopenic dysphagia in older people

Wakabayashi, Hidetaka

doi:10.1111/ggi.14651

Cited by 11 publications

(4 citation statements)

References 9 publications

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“…Given that electrolyte abnormalities, malnutrition, and sarcopenia are frequently found in older patients undergoing post-stroke rehabilitation, 41 , 42 ) it may be necessary to implement the triad of rehabilitation, nutrition, and oral management. 43 , 44 , 45 ) This multifaceted approach aims to enhance nutritional status, oral health, and overall functional recovery, highlighting the significance of integrated patient care through perspectives such as rehabilitation nutrition 46 , 47 , 48 ) and rehabilitation pharmacotherapy. 19 , 49 , 50 )…”

Section: Discussionmentioning

confidence: 99%

Associations between Baseline Hyponatremia and Activities of Daily Living and Muscle Health in Convalescent Stroke Patients

Yoshimura,

Wakabayashi,

Nagano

et al. 2024

PRM

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Objectives: Evidence is scarce regarding the association between hyponatremia and functional outcomes among older hospitalized patients. We aimed to evaluate the associations between baseline hyponatremia and improvement in activities of daily living (ADL) and muscle health in hospitalized post-stroke patients. Methods: This retrospective cohort study included hospitalized post-stroke patients. Serum sodium concentrations were extracted from medical records based on blood tests performed within 24 h of admission, with hyponatremia defined as a serum sodium concentration below135 mEq/L. Primary outcome was the discharge ADL as assessed by the motor domain of the Functional Independence Measure (FIM-motor) and its corresponding gain during hospitalization. Other outcomes encompassed the discharge scores for skeletal muscle mass (SMI) and handgrip strength (HGS). Multivariate linear regression analyses were used to determine the association between hyponatremia and outcomes of interest, adjusted for potential confounders. Results: Data from 955 patients (mean age 73.2 years; 53.6% men) were analyzed. The median baseline blood sodium level was 139 [interquartile range: 137, 141] mEq/L, and 84 patients (8.8%) exhibited hyponatremia. After full adjustment for confounders, baseline hyponatremia was significantly and negatively associated with FIM-motor at discharge (β=−0.036, P=0.033) and its gain during hospital stay (β=−0.051, P=0.033). Baseline hyponatremia exhibited an independent and negative association with discharge HGS (β=−0.031, P=0.027), whereas no significant association was found between baseline hyponatremia and discharge SMI (β=−0.015, P=0.244). Conclusions: Baseline hyponatremia demonstrated a correlation with compromised ADL and muscle health in individuals undergoing rehabilitation after stroke.

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Section: Discussionmentioning

confidence: 99%

Associations between Baseline Hyponatremia and Activities of Daily Living and Muscle Health in Convalescent Stroke Patients

Yoshimura,

Wakabayashi,

Nagano

et al. 2024

PRM

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“…To prevent the decline in ADL and cognitive level and to help maximize the improvement in outcomes in these patients, comprehensive multidisciplinary management, including nutritional management and rehabilitation before or early after surgery, is necessary [56][57][58]. Furthermore, since older patients after hip fractures are at a higher risk for malnutrition and sarcopenia [37,59], the triad of rehabilitation, nutrition, and oral management should be implemented while managing HF [60,61].…”

Section: Discussionmentioning

confidence: 99%

Concurrent Negative Impact of Undernutrition and Heart Failure on Functional and Cognitive Recovery in Hip Fracture Patients

Kamijikkoku,

Yoshimura

2023

Nutrients

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Evidence on the effects of frailty, undernutrition, and heart failure (HF) on patients with hip fractures is scarce. This retrospective cohort study aimed to examine the effects of undernutrition and HF on outcomes in patients who underwent convalescent rehabilitation after hip fracture. Undernutrition was defined as body mass index (BMI) < 20.0 (Low BMI). Heart failure (HF) was defined as a B-type natriuretic peptide (BNP) > 100 (High BNP). The study outcomes included the Functional Independence Measure motor domain (FIM-motor) and cognitive domain (FIM-cognition) at discharge. To consider the effects of low BMI, high BNP, and the simultaneous presence of both (“low BMI and high BNP”), we used multivariate linear regression analyses to examine whether these were associated with the outcomes. A total of 110 (mean age 87.4 years, 24.8% male) were analyzed. As a result, low BMI (β = −0.088, p = 0.027) and high BNP (β = −0.053, p = 0.015), each alone, were significantly associated with the FIM motor at discharge, whereas the simultaneous presence of “low BMI and high BNP” was significantly associated with the FIM motor at discharge, while the strength of the association was greater than each association alone (β = −0.152, p = 0.010). Further, the simultaneous presence of “low BMI and high BNP” was significantly associated with FIM cognition at discharge (β = −0.109, p = 0.014). Comprehensive multidisciplinary management is needed, including preoperative or early postoperative nutritional support and rehabilitation, followed by rehabilitation nutrition care management, in patients with hip fracture.

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“…Adequate nutrition is essential for enhancing the effectiveness of rehabilitation through strength training, and the concept of rehabilitation nutrition is gaining increasing recognition ( 38 ). The importance of the trinity of rehabilitation, nutrition, and oral management for sarcopenic dysphagia in older adults is emphasized ( 39 ). Taste is essential to sustain life, and its primary function is to facilitate the intake of essential nutrients and the rejection of harmful substances.…”

Section: Rehabilitation Nutrition and Tastementioning

confidence: 99%

The importance of taste on swallowing function

Okubo,

Morishita,

Odani

et al. 2024

Front. Nutr.

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The world’s population is aging. Pneumonia is the leading cause of death among the older adults, with aspiration pneumonia being particularly common. Aspiration pneumonia is caused by a decline in swallowing function. Causes can include age-related sarcopenia of swallowing muscles, cognitive decline, cerebrovascular and other diseases or even changes in individual taste preference. Currently, the main treatment approach for dysphagia is resistance training of swallowing-related muscles. This approach has not been effective and establishment of novel methods are required. In this review, we introduce and discuss the relationship between taste, taste preference, carbonation and swallowing function. Taste and preference improve swallowing function. Recently, it has been shown that a carbonated beverage that combines the functionality of a thickening agent, the appeal of taste, and the stimulation of carbonation improves swallowing function. This may be very useful in the recovery of swallowing function. It is important to note that deliciousness is based not only on taste and preference, but also on visual information such as food form. Umami taste receptors are expressed not only in taste buds but also in skeletal muscle and small intestine. These receptors may be involved in homeostasis of the amino acid metabolic network, i.e., the process of amino acid ingestion, intestine absorption, and storage in skeletal muscle. Proper stimulation of umami receptors in organs other than taste buds may help maintain nutritional status and muscle mass. Umami receptors are therefore a potential therapeutic target for dysphagia.

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Triad of rehabilitation, nutrition, and oral management for sarcopenic dysphagia in older people

Cited by 11 publications

References 9 publications

Associations between Baseline Hyponatremia and Activities of Daily Living and Muscle Health in Convalescent Stroke Patients

Associations between Baseline Hyponatremia and Activities of Daily Living and Muscle Health in Convalescent Stroke Patients

Concurrent Negative Impact of Undernutrition and Heart Failure on Functional and Cognitive Recovery in Hip Fracture Patients

The importance of taste on swallowing function

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