Clinical and functional assessment of swallowing of older patients with or without complaints of dysphagia admitted to a care geriatric ward / "Avaliação estrutural e funcional da deglutição de idosos, com e sem queixas de disfagia, internados em uma enfermaria geriátrica"

AUTOR(ES)
DATA DE PUBLICAÇÃO

2003

RESUMO

Physiological mechanisms change during the aging process. Among the changes that occur naturally during this process, there are the problems of swallowing. Swallowing integrity not only warrants the maintenance of the patient’s nutritional status, but also protects the respiratory system against accidents like the aspiration of oropharyngeal contents. On the other hand, changes in the swallowing process, often added by other diseases, induces nutritional and infectious complications, favoring the occurrence of other diseases and, even, irreversible clinical pictures. The present study aimed to assess the oropharyngeal phase of swallowing of older persons admitted to the wards of the Division of General Internal Medicine and Geriatric Medicine of the Internal Medicine Department of the School of Medicine of Ribeirão Preto – University of São Paulo, independently of the presence or absence of swallowing complaints, through phonoaudiological clinical evaluation and cintilographic study of swallowing. Thirty elderly patients were studied, with age ranging from 66 to 94 years old, mean age 80 years, randomly selected, without being taken into consideration specific diseases and the presence or absence of swallowing complaints. Severely compromised Patients, whose health status made impossible adequate evaluation, were excluded. Two control groups were composed, one of young volunteers, aged from 21 to 30 years, mean age 25 years and one of elderly volunteers, with age ranging from 60 to 80 years old, mean age 70 years. Volunteers of the control groups were carefully evaluated before participation, to make sure that they did not have swallowing difficulties and/or clinical conditions that could influence swallowing and oral and facial motor performance and did not take medications with central nervous system actions. For functional assessment of swallowing, the study participants swallowed two boluses of 5 ml each, in liquid and syrup consistence. In the cintilographic study, a radioactive tracer (99mTc colloidal phytate) was added to the boluses. Data were analyzed through the gamma-camera acquisition protocol (vision DST) for oral transit and residual, pharyngeal transit, clearance time and residual and time for proximal esophagus entrance. The study allowed us to conclude that older patients without swallowing complaints and without diseases that cause dysphagia, do not show significant differences of the observed parameters when compared to healthy older persons. Older persons swallow slower when compared to younger persons, however this delay allows them to swallow safer. Changes in dietary habits of older persons should be questioned by professionals that work with geriatric populations and clinical phonoaudiological assessment of swallowing must be part of the assessment process of situations where difficulties for swallowing appeared, being absolutely necessary for those that present diseases that courses with dysphagia. The cintilographic technique is sensitive to subtle changes in transit, clearance and food residuals.

ASSUNTO(S)

deglutição scintigraphy idoso swallowing dysphagia older disfagia cintilografia

ACESSO AO ARTIGO

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