ワカバヤシ ヒデタカ   Wakabayashi Hidetaka
  若林 秀隆
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Cognitive impairment has no impact on hospital-associated dysphagia in aspiration pneumonia patients.
掲載誌名 正式名:Geriatrics & gerontology international
略  称:Geriatr Gerontol Int
ISSNコード:14470594/14470594
掲載区分国外
巻・号・頁 18(2),pp.233-239
著者・共著者 Maeda Keisuke, Wakabayashi Hidetaka, Shamoto Hiroshi, Akagi Junji
担当区分 2nd著者
発行年月 2018/02
概要 AIM:Hospital-associated dysphagia, characterized by deconditioning of swallowing as a result of hospitalization, is sometimes observed in patients with aspiration pneumonia (AP). Cognitive impairment is known as a negative factor in dysphagia rehabilitation. The present study aimed to examine the association between cognitive impairment and hospital-associated dysphagia in patients with AP receiving dysphagia rehabilitation.METHODS:A retrospective observational study was carried out in an acute geriatric hospital. A total of 249 AP patients receiving multidisciplinary individualized dysphagia rehabilitation were included. Patients were divided into four groups according to their Mini-Mental State Examination scores. The Functional Oral Intake Scale (FOIS) was used to assess swallowing ability, and hospital-associated dysphagia was defined as a FOIS decline of ≥1 or ≥2 levels. Body mass index and Barthel Index were obtained to assess nutritional status and activities of daily living.RESULTS:The mean age was 85.6 ± 7.3 years, and 47% were men. Frequencies of hospital-associated dysphagia observed in lowest to highest Mini-Mental State Examination groups were 43.0%, 36.2%, 47.4% and 27.3% (P = 0.133), and 13.9%, 20.7%, 17.5% and 5.5% (P = 0.117) based on FOIS decline ≥1 or ≥2 levels, respectively. Multivariable regression model showed that the Mini-Mental State Examination score was not an independent determinant of FOIS at discharge (beta = 0.063, P = 0.378) after adjusting for age, sex, body mass index, Barthel Index, pneumonia severity, speech-language pathologist intervention, comorbidities, length of hospital stay and premorbid FOIS.CONCLUSIONS:The severity of cognitive impairment has no impact on hospital-associated dysphagia in AP patients receiving dysphagia rehabilitation. A future interventional study will be expected to further validate our findings. Geriatr Gerontol Int 2018; 18: 233-239.
DOI 10.1111/ggi.13164
PMID 28940784