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A Multidisciplinary Approach to Managing Swallowing Dysfunction in Older People / edited by Pere Clavé and Omar Ortega.

Elsevier ScienceDirect eBook - Translational Medicine 2024 Available online

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Format:
Book
Author/Creator:
Clave´, Pere
Contributor:
Clavé, Pere, editor.
Ortega, Omar, editor.
Language:
English
Subjects (All):
Geriatrics.
Deglutition disorders--Treatment.
Deglutition disorders.
Physical Description:
1 online resource (336 pages)
Edition:
First edition.
Place of Publication:
Cambridge, MA : Academic Press, [2024]
Summary:
A Multidisciplinary Approach to Managing Swallowing Dysfunction in Older People provides comprehensive coverage on oropharyngeal dysphagia (OD), focusing on older patient phenotypes.
Contents:
Front Cover
A Multidisciplinary Approach to Managing Swallowing Dysfunction in Older People
Copyright
Contents
Contributors
Preface
Acknowledgments
Prologue
1 - Introduction
References
2 - Oropharyngeal dysphagia as a geriatric syndrome
Introduction
Definition of a geriatric syndrome
Review of the criteria to define OD as a geriatric syndrome
High prevalence in older persons
OD includes a combination of symptoms
Common risk factors with other geriatric syndromes
Interactions with other geriatric syndromes and pathologies
Impaired clinical outcomes associated with OD
Multicomponent intervention
Conclusion
3 - Physiology and pathophysiology
3.1 - Physiology and pathophysiology of oropharyngeal dysphagia in older persons
Physiology of swallowing in healthy subjects
Anatomical and physiological changes in older adults
Main causes of OD
Oral impairment
Pharyngeal impairment
Impaired transport
Obstruction
Protection of the airway
Coordination of breathing and swallowing
Geriatric OD
Pathophysiological characterization of impaired swallowing in older adults
Biomechanical and OSR impairments in older patients with OD
Neurophysiological impairments of OD
Impaired motor pathway on older patients with OD
Impaired sensory pathway on older patients with OD
Summary and discussion
3.2 - Brain structure, neurotopography, and function in dysphagia in older persons
Cortical and subcortical control of swallowing
Age-related changes of the central control of swallowing
4 - Sarcopenic dysphagia
An introduction to sarcopenia
Definition of 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
Sarcopenia and dysphagia
Malnutrition and dysphagia in older people
Texture-modified diets and malnutrition
The vicious circle of dysphagia, malnutrition, and sarcopenia
The definition and diagnosis of sarcopenic dysphagia
Definition of sarcopenic dysphagia
Diagnosis of sarcopenic dysphagia
Prevalence of sarcopenic dysphagia
Ultrasonography of swallowing muscle mass and intensity
Clinical signs of sarcopenic dysphagia
Prevention and treatment of sarcopenic dysphagia
Prevention of sarcopenic dysphagia
Iatrogenic sarcopenia
Treatment of sarcopenic dysphagia
Conclusions
5 - Diagnosis of dysphagia in the older person
Clinical history and patient/carer interview
Screening for dysphagia
Clinical swallowing examination
Instrumental assessments and neurophysiological approaches
5.1 - Dysphagia diagnosis: Noninstrumental assessment
Swallow screening
The importance of early screening
Variations of screening tests
Water swallow tests
Screening tests involving different consistencies
Training in screening
The importance of validation and diagnostic accuracy in selecting a screening test
Summary
Clinical swallow evaluation
Components of the CSE
Case history
Orofacial examination
Swallow trials
Adjunct evaluation tools
Standardized clinical swallow evaluation tools
Outcome measures based on the CSE
5.2 - Instrumental assessment (VFS, FEES, and HRM)
Videofluoroscopy swallowing study
VFS advantages and indications.
VFS disadvantages, limitations, and contraindications
Professionals performing VFS
VFS protocol
VFS scoring methods
VFS-oropharyngeal swallow response
VFS signs of impaired safety and efficacy of swallow in older adults
Oropharyngeal swallow response in older adults
FEES
FEES advantages
Contraindications to FEES
Professionals performing FEES
FEES protocol
FEES metrics
FEES in older adults
HRM-pharyngeal-esophageal high-resolution manometry
Definition of the technique and instrumentation
Patient preparation and performance protocol
PhHRM metrics
UES relaxation and opening
Metrics of flow resistance through the UES
Metrics of pharyngeal propulsive forces
Other metrics associated with impedance
Pharyngeal high-resolution manometry in older patients
5.3 - Other techniques to assess the swallowing function (neurophysiology-pSEPs, pMEPs, EMG, accelerometry, ultraso ...
Neurophysiology
General principles and techniques
Evoked potentials and TMS-related techniques for swallowing assessment
Swallowing motor- and sensory-evoked potentials
Other excitability measures for swallowing assessment
Electromyographic and accelerometric assessments
Electrokinesiographic assessment of oropharyngeal swallowing (single-bolus analysis)
Assessment of the shape and reproducibility of swallowing-related bioelectric signals (sequential swallowing analysis)
Spontaneous swallowing frequency assessment
Ultrasound
Ultrasonography
Neuromuscular US in the evaluation of physiological swallow and dysphagia
6 - Complications of oropharyngeal dysphagia
6.1 - Dehydration
Definition
Etiology
Prevalence of dehydration in patients with OD
Diagnosis
Complications
Management.
Free water protocols
Other management
6.2 - Malnutrition
Prevalence
Classification and types
Disease-related malnutrition
Malnutrition
Disease-related malnutrition with inflammation
Chronic DRM with a milder inflammatory response. Chronic DRM with inflammation. Synonym: Cachexia
Acute disease- or injury-related malnutrition that is characterized by a strong inflammatory response
Disease-related malnutrition without inflammation. Synonym: Noncachectic DRM
Malnutrition/undernutrition without disease. Synonym: Non-DRM
Hunger-related malnutrition
Socioeconomic or psychologic-related malnutrition
Sarcopenia
Frailty
Overnutrition (overweight and obesity)
Micronutrient abnormalities (deficiency or excess)
Nutritional screening and assessment
Treatment [29,34,139-143]
Highlights for specific patient populations
Older patients with OD
Poststroke OD
Cerebral palsy and neurological disabilities
Amyotrophic lateral sclerosis [140]
Parkinson's disease [140,167]
Dementia [140,169]
Head and neck cancer [141,142,170-172]
Patients with COVID-19
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
6.4 - Respiratory infections and aspiration pneumonia
Epidemiology
Treatment
When antibiotics are necessary?
Which antibiotics to use?
Duration and escalation/de-escalation of antibiotic treatment
Prevention
Prognosis
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
Functional capacity
Disability, handicap, and functional capacity
ICF Codes
Functional capacity and dysphagia
Does dysphagia affect functional capacity?
Dysphagia and institutionalization
Prevalence of dysphagia
Risk feeding
Presentation of dysphagia
Complications associated with dysphagia in institutionalized settings
Medication
Nutrition
Infection
Dehydration
7 - Treatment
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
Basic concepts of shear viscosity
Basic concepts of extensional rheology
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
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
The texture profile analysis
Sensory analysis tools for texture-modified diets.
Hedonic test for texture-modified diets.
Notes:
Includes bibliographical references and index.
Description based on publisher supplied metadata and other sources.
Description based on print version record.
Other Format:
Print version: Clave´, Pere A Multidisciplinary Approach to Managing Swallowing Dysfunction in Older People
ISBN:
9780323916875
9780323916868
0323916864
0323916872
OCLC:
1428503226

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