老年人肌少症性吞咽障碍患病率及危险因素的系统评价

doi:10.3969/j.issn.1003-9198.2022.04.016

摘要/Abstract

摘要： 目的系统评价老年人肌少症性吞咽障碍的患病率及危险因素。方法检索PubMed、EMbase、The Cochrane Library、Web of Science、CINAHL、CNKI、CBM、WanFang Data和VIP数据库,搜集关于老年人肌少症性吞咽障碍的相关研究,检索时限均为建库至2020年6月。采用Stata 12.0软件进行Meta分析。危险因素采用描述性分析。结果共纳入10项研究,包括4039例病人。Meta分析结果显示,≥60岁老年人肌少症性吞咽障碍的患病率为4.0%(95%CI:3.0%～4.0%)。亚组分析显示:老年女性、年龄>80岁、采用小腿围和食物水平摄入量表(Food Intake Level Scales,FILS)评估的老年人肌少症性吞咽障碍的患病率更高;描述性分析显示,影响老年人肌少症性吞咽障碍发生的因素包括舌肌力量、肌肉质量、握力、身体状况、营养状况、能量摄入等。结论老年人肌少症性吞咽障碍的患病率较高;舌力和肌肉质量降低、握力低、身体状况差、营养失调以及能量摄入不足等可增加老年人发生肌少症性吞咽障碍的风险。

关键词: 老年人, 肌少症性吞咽障碍, 患病率, 危险因素, 系统评价

Abstract: Objective To determine the prevalence and risk factors of sarcopenic dysphagia in the elderly by systematic review. Methods PubMed, EMbase, The Cochrane Library, Web of Science, CINAHL, CNKI, CBM, WanFang Data and VIP databases were searched to collect studies on the prevalence and influencing factors of sarcopenic dysphagia in the elderly from inception to June 2020. Meta analysis was then performed by using Stata 12.0 software. Descriptive analysis was used to analyze the risk factors. Results Finally 10 studies involving 4039 patients were included.The Meta analysis showed that the prevalence of sarcopenic dysphagia in the elderly (≥60 years old) was 4.0%(95%CI:3.0%- 4.0%). Subgroup analysis showed that the prevalence of sarcopenic dysphagia was higher in elderly females,>80 years old, and assessed by calf circumference and Food Intake Level Scales(FILS). Descriptive analysis showed that the factors that affecting sarcopenic dysphagia in the elderly including tongue muscle strength, muscle mass, grip strength, physical condition, nutritional status, energy intake. Conclusions The prevalence of sarcopenic dysphagia in the elderly is relatively high. Reduced tongue strength and muscle mass,low grip strength,poor physical condition,poor nutrition,and inadequate energy intake may increase the risk of sarcopenic dysphagia in the elderly.

Key words: aged, sarcopenic dysphagia, prevalence, risk factors, systematic review

中图分类号:

R 746

李雯艳, 路娜, 阮海慧, 刘瑾, 袁蓉敬, 王叶同, 苏庆玲, 王艳红. 老年人肌少症性吞咽障碍患病率及危险因素的系统评价[J]. 实用老年医学, 2022, 36(4): 390-394.

LI Wen-yan, LU Na, RUAN Hai-hui, LIU Jin, YUAN Rong-jing, WANG Ye-tong, SU Qing-ling, WANG Yan-hong. Prevalence and risk factors of sarcopenic dysphagia in elderly: a systematic review[J]. Practical Geriatrics, 2022, 36(4): 390-394.

参考文献

[1] KAWAKAMI R, MURAKAMI H, SANADA K, et al. Calf circumference as a surrogate marker of muscle mass for diagnosing sarcopenia in Japanese men and women[J]. Geriatr Gerontol Int, 2015, 15(8): 969-976.
[2] MAEDA K, AKAGI J. Sarcopenia is an independent risk factor of dysphagia in hospitalized older people[J]. Geriatr Gerontol Int, 2016, 16(4): 515-521.
[3] MAEDA K, AKAGI J. Treatment of sarcopenic dysphagia with rehabilitation and nutritional support: a comprehensive approach[J]. J Acad Nutr Diet, 2016, 116(4): 573-577.
[4] KURODA Y, KURODA R. Relationship between thinness and swallowing function in Japanese older adults: implications for sarcopenic dysphagia[J]. J Am Geriatr Soc, 2012, 60(9): 1785-1786.
[5] FUJISHIMA I, FUJIU-KURACHI M, ARAI H, et al. Sarcopenia and dysphagia: position paper by four professional organizations[J]. Geriatr Gerontol Int, 2019, 19(2): 91-97.
[6] WAKABAYASHI H. Presbyphagia and sarcopenic dysphagia: association between aging, sarcopenia, and deglutition disorders[J]. J Frailty Aging, 2014, 3(2): 97-103.
[7] FIRAT OZER F, AKIN S, SOYSAL T, et al. Relationship between dysphagia and sarcopenia with comprehensive geriatric evaluation[J]. Dysphagia, 2021, 36(1): 140-146.
[8] MAEDA K, AKAGI J. Decreased tongue pressure is associated with sarcopenia and sarcopenic dysphagia in the elderly[J]. Dysphagia, 2015, 30(1): 80-87.
[9] SAKAI K, NAKAYAMA E, TOHARA H, et al. Diagnostic accuracy of lip force and tongue strength for sarcopenic dysphagia in older inpatients: a cross-sectional observational study[J]. Clin Nutr, 2019, 38(1): 303-309.
[10] CHA S, KIM W S, KIM K W, et al. Sarcopenia is an independent risk factor for dysphagia in community-dwelling older adults[J]. Dysphagia, 2019, 34(5): 692-697.
[11] OGAWA N, MORI T, FUJISHIMA I, et al. Ultrasonography to measure swallowing muscle mass and quality in older patients with sarcopenic dysphagia[J]. J Am Med Dir Assoc, 2018, 19(6): 516-522.
[12] MAEDA K, ISHIDA Y, NONOGAKI T, et al. Development and predictors of sarcopenic dysphagia during hospitalization of older adults[J]. Nutrients, 2019, 12(1): 70.
[13] MAEDA K, TAKAKI M, AKAGI J. Decreased skeletal muscle mass and risk factors of sarcopenic dysphagia: a prospective observational cohort study[J]. J Gerontol A Biol SCI Med SCI, 2017, 72(9): 1290-1294.
[14] AGANO A, MAEDA K, SHIMIZU A, et al. Association of sarcopenic dysphagia with underlying sarcopenia following hip fracture surgery in older women[J]. Nutrients, 2020, 12(5): 1365.
[15] WAKABAYASHI H, TAKAHASHI R, MURAKAMI T. The prevalence and prognosis of sarcopenic dysphagia in patients who require dysphagia rehabilitation[J]. J Nutr Health Aging, 2019, 23(1): 84-88.
[16] JONES C M, BOELAERT K. The endocrinology of ageing: a mini-review[J]. Gerontology, 2015, 61(4): 291-300.
[17] PROVINCE M A, HADLEY E C, HORNBROOK M C, et al. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques[J]. JAMA, 1995, 273(17): 1341-1347.
[18] HAIZLIP K M, HARRISON B C, LEINWAND L A. Sex-based differences in skeletal muscle kinetics and fiber-type composition[J]. Physiology:Bethesda, 2015, 30(1): 30-39.
[19] 赵文婷, 杨茗, 张雪梅, 等. 肌少症所致吞咽障碍的研究进展[J]. 国际老年医学杂志, 2019, 40(1): 55-58.
[20] MAEDA K, KOGA T, NASU T, et al. Predictive accuracy of calf circumference measurements to detect decreased skeletal muscle mass and European society for clinical nutrition and metabolism-defined malnutrition in hospitalized older patients[J]. Ann Nutr Metab, 2017, 71(1/2): 10-15.
[21] KUNIEDA K, OHNO T, FUJISHIMA I, et al. Reliability and validity of a tool to measure the severity of dysphagia: the Food Intake LEVEL Scale[J]. J Pain Symptom Manage, 2013, 46(2): 201-206.
[22] 贾春玲, 张乔, 孟春英, 等. 老年人吞咽障碍筛查与评估工具研究进展[J]. 当代护士: 下旬刊, 2019, 26(8): 14-16.
[23] 李博宁, 陈健尔.肌少症相关吞咽障碍的研究进展[J]. 中国康复理论与实践, 2020, 26(3): 344-349.