A Multidisciplinary Approach to Managing Swallowing Dysfunction in Older People

1st Edition - March 29, 2024
Authors: Pere Clave´, Omar Ortega
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 9 1 6 8 6 - 8
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 9 1 6 8 7 - 5

A Multidisciplinary Approach to Managing Swallowing Dysfunction in Older People provides comprehensive coverage on oropharyngeal dysphagia (OD), focusing on older patient phenotype… Read more

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A Multidisciplinary Approach to Managing Swallowing Dysfunction in Older People provides comprehensive coverage on oropharyngeal dysphagia (OD), focusing on older patient phenotypes. The book provides the knowledge needed for translational researchers and professionals to aid in the detection, diagnosis, treatment and management of OD, ultimately improving patient quality of life. OD has been recently considered a geriatric syndrome because of its high prevalence, the increase of life-expectancy and the need to be managed by a multidisciplinary approach. This reference takes a novel approach to OD, covering all aspects as a geriatric syndrome, examining a complicated and multi-level topic in a succinct way.

Contents include the most innovative information available in current literature combined with practical applications to improve the diagnosis and treatments of OD as a geriatric syndrome. This is the perfect reference for translational researchers, physicians and healthcare professionals dealing with OD.

Cover image
Title page
Table of Contents
Copyright
Contributors
Preface
Acknowledgments
Prologue
Chapter 1. Introduction
Chapter 2. Oropharyngeal dysphagia as a geriatric syndrome
Introduction
Review of the criteria to define OD as a geriatric syndrome
Conclusion
Chapter 3. Physiology and pathophysiology
Chapter 3.1. Physiology and pathophysiology of oropharyngeal dysphagia in older persons
Introduction
Chapter 3.2. Brain structure, neurotopography, and function in dysphagia in older persons
Introduction
Cortical and subcortical control of swallowing
Age-related changes of the central control of swallowing
Conclusion
Chapter 4. Sarcopenic dysphagia
An introduction to sarcopenia
Pathophysiology of sarcopenia
Diagnosis of sarcopenia
Prevalence and consequences of sarcopenia
Prevention and treatment of sarcopenia
The relationship between dysphagia, malnutrition, and sarcopenia in older people
Malnutrition and dysphagia in older people
Texture-modified diets and malnutrition
The vicious circle of dysphagia, malnutrition, and sarcopenia
Prevalence of sarcopenic dysphagia
Ultrasonography of swallowing muscle mass and intensity
Clinical signs of sarcopenic dysphagia
Iatrogenic sarcopenia
Treatment of sarcopenic dysphagia
Conclusions
Chapter 5. Diagnosis of dysphagia in the older person
Introduction
Chapter 5.1. Dysphagia diagnosis: Noninstrumental assessment
Swallow screening
Clinical swallow evaluation
Chapter 5.2. Instrumental assessment (VFS, FEES, and HRM)
Videofluoroscopy swallowing study
FEES
HRM—pharyngeal-esophageal high-resolution manometry
Chapter 5.3. Other techniques to assess the swallowing function (neurophysiology—pSEPs, pMEPs, EMG, accelerometry, ultrasonography, and spontaneous swallowing frequency)
Neurophysiology
Ultrasound
Chapter 6. Complications of oropharyngeal dysphagia
Introduction
Chapter 6.1. Dehydration
Introduction
Definition
Etiology
Prevalence of dehydration in patients with OD
Diagnosis
Complications
Management
Other management
Chapter 6.2. Malnutrition
Introduction
Definition
Prevalence
Etiology
Classification and types
Nutritional screening and assessment
Treatment [29,34,139–143]
Chapter 6.3. Oral health
Impact of oral diseases on oropharyngeal dysphagia
Impact of oral diseases on aspiration pneumonia
Oral management/prevention of OD and aspiration pneumonia
Conclusions
Chapter 6.4. Respiratory infections and aspiration pneumonia
Introduction
Epidemiology
Diagnosis
Treatment
Prevention
Prognosis
Summary
Chapter 6.5. Frailty, functional capacity, institutionalization, and quality of life
Eating, drinking, and swallowing problems in frail older adults
Swallowing with age
Oral frailty
Frailty, sarcopenia, and swallowing
Summary
Functional capacity
Dysphagia and institutionalization
Chapter 7. Treatment
Chapter 7.1. Thickening products and alimentary fluids for older patients with swallowing disorders
Brief introduction to the state of the art of fluid thickening in older patients with oropharyngeal dysphagia
The scientific method. How to measure the effect of rheology? The SI of units
Thickening products
Rheology for deglutologists
An in vitro protocol to assess the rheological properties of TP
In vitro assessment of extensional viscosity
Clinical studies supporting the therapeutic effect of TP
Palatability and compliance and potential side effects of TP
Viscosity classifications for TP for patients with OD
Regulations and legal framework
Labeling of thickening products and thickened fluids
Rheological fluid characterization of main alimentary fluids
Supplementary material
Chapter 7.2. Texture-modified foods for patients with swallowing and/or mastication impairments
Basics of the physiology of solid food processing
Understanding the concepts of food texture and texture-modified diets
Characterization of texture-modified foods in the international system of units
Sensory analysis tools for texture-modified diets
Chapter 7.3. Multimodal interventions—the role of the multidisciplinary team
Multidisciplinary team description
Demographic and patient-centered care context
Needs to share decisions to manage several phenotypes of OD patients
Professional roles and service organization
Multimodal interventions
Chapter 7.4. Classical rehabilitation strategies
Introduction
Treatment
Swallowing rehabilitation and neuroplasticity
Chapter 7.5. Pharmacological treatment
Neurophysiology of swallowing and sensory innervation of the human oropharynx
Structures and receptors involved in the sensory perception
Effect of chemical and physical stimulation on biomechanics and neurophysiology of swallowing
Chapter 7.6. Neurorehabilitation strategies
7.6.1. Neurorehabilitation for oropharyngeal dysphagia in older patients
7.6.2. Transcutaneous electrical stimulation: neuromuscular and sensory stimulation for poststroke older patients with oropharyngeal dysphagia
Chapter 8. Health economics of oropharyngeal dysphagia and its complications: Malnutrition and respiratory infections in older people
Oropharyngeal dysphagia in geriatric populations
Poststroke oropharyngeal dysphagia
Clinical complications of poststroke oropharyngeal dysphagia: malnutrition and respiratory infections
Oropharyngeal dysphagia in head and neck cancer
Oropharyngeal dysphagia in Parkinson's disease
Economic evaluation studies of healthcare interventions in oropharyngeal dysphagia
Conclusions
Chapter 9. The development of scientific societies, history of dysphagia management and research in Europe, UK, North America, Australia, New Zealand, South America, Japan, Korea, and China
European society for swallowing disorders
UK swallowing research group
North America
New Zealand and Australia
South America. Sociedad Latinoamericana de disfagia
Japan
Korea
China
Chapter 10. Summary and conclusions
Index

Pere Clave´

Pere Clavé is a digestive surgeon, professor at the Universitat Autònoma de Barcelona (UAB) and Director of Research and Innovation at the Consorci Sanitari del Maresme. He has an extensive career in the world of research and more specifically in GI physiology. Dr. Clavé is also the Founding President of the European Society for Swallowing Disorders (ESSD) and founder of the Fundació de Recerca en Gastroenterologia (Gastroenterology Research Foundation (FUREGA)). He is also head of the Digestive Motility Department at Hospital de Mataró, a multidisciplinary unit that works in conjunction for the diagnosis, treatment and research of oropharyngeal dysphagia. His proactivity in spreading knowledge on dysphagia to professionals from all over the word is well known: he is the director of the Master’s Degree and Postgraduate Diploma on Swallowing Disorders, multidisciplinary courses offered by the UAB; and he is also the coordinator of an online practicum available for SLP students at UAB focused on dysphagia.

Affiliations and expertise

Prof. Pere Clave is a digestive surgeon, professor at the Universitat Autònoma de Barcelona (UAB), Director of Research and Innovation at the Consorci Sanitari del Maresme and principal investigator of the CIBERehd (Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III) group on Gastrointestinal Physiology.

Omar Ortega

Omar Ortega is a postdoctoral researcher at Hospital de Mataró (Fundació Salut del Consorci Sanitari del Maresme) and affiliate partner of the Center for Biomedical Research in Hepatic and Digestive Diseases Network (CIBERehd, Instituto de Salud Carlos III; https://www.ciberehd.org). Degree in Biology. Master’s Degree in Advanced Microbiology from the Universitat de Barcelona. Doctor in Medicine (2016) at Universitat Autònoma de Barcelona. His research line has been focused on the respiratory complications of oropharyngeal dysphagia (OD) in older patients, the study of the pathophysiology of OD in older and post-stroke patients with new neurophysiological approaches and the development of new neurorehabilition treatments for these patients.

Affiliations and expertise

Dr. Omar Ortega is a postdoctoral researcher at Hospital de Mataró (Fundació Salut del Consorci Sanitari del Maresme) and affiliate partner of CIBERehd (Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III).