scholarly journals Bolus Airway Invasion Observed During Videofluoroscopy in Healthy, Non-dysphagic Community-Dwelling Adults

2019 ◽  
Vol 128 (5) ◽  
pp. 426-432 ◽  
Author(s):  
Kendrea L. (Focht) Garand ◽  
Elizabeth G. Hill ◽  
Elaine Amella ◽  
Kent Armeson ◽  
Alonna Brown ◽  
...  

Objectives: Typical aging may result in subclinical swallowing alterations (presbyphagia), which can place an individual at risk for dysphagia-related conditions, such as aspiration pneumonia, secondary to loss of functional reserve and rising incidence of age-related diseases associated with dysphagia. The purpose of this study was to investigate occurrence of airway invasion among healthy, nondysphagic community-dwelling adults. Further, we tested for differences of airway invasion across age categories and between sexes. Methods: Each eligible participant underwent a videofluoroscopic swallow study using a standardized approach of various volumes and viscosities. Ten swallows observed in the lateral viewing plane was assessed for observation of bolus airway invasion using the Penetration-Aspiration Scale (PAS) scoring system. Eligible participants (N = 195) were categorized according to 1 of 3 age categories (21-39 years, 40-59 years, 60 years and older) and sex (male, female) for analyses. Results: Out of 1936 swallows analyzed, we observed penetration in 113 swallows (5.8%) and aspiration in 6 swallows (0.3%). Majority (98%) of bolus airway invasion events occurred during the swallow. Mean or worst PAS scores did not significantly differ across age categories or between sexes. The odds ratios of PAS impairment between age categories did not reveal any significant differences. Males were more likely to have impaired PAS scores relative to females (odds ratio [OR] = 3.5; P = .01). Conclusions: Entrance of ingested material into the airway observed during videofluoroscopy is uncommon in healthy adults, which helps support the notion that aging may not directly correlate with increased risk of aspiration. Rather, the increased risk of aspiration observed in the aging population may result from the increased incidence of neurological and other diseases with dysphagia as common sequelae with advancing age. Future investigations should compare age-matched healthy controls with a diseased population (eg, cerebral vascular accident) to further explore the relationship between aspiration risk as a function of age compared to consequence of disease/injury.

2019 ◽  
Vol 98 (5) ◽  
pp. 534-540 ◽  
Author(s):  
K. Takeuchi ◽  
K. Matsumoto ◽  
M. Furuta ◽  
S. Fukuyama ◽  
T. Takeshita ◽  
...  

Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.


2020 ◽  
Vol 21 (2) ◽  
pp. 89-107
Author(s):  
Reona Chiba ◽  
Yuki Ohashi ◽  
Akiko Ozaki

Purpose Several epidemiological studies have reported an age-related increase in the prevalence of sleep disturbances. This study aims to investigate the relationship between sleep and sarcopenia/frailty in older adults and clarify issues that remain to be addressed in future studies. Design/methodology/approach PubMed was searched for relevant studies with the following keywords in the title: “sleep” and “sarcopenia” or “sleep” and “frailty.” A total of 15 studies published in English between 1998 and 2018 were reviewed. Findings Among the four studies that examined the relationship between sarcopenia and sleep, two reported that long or short sleep duration increased the risk of sarcopenia and this association was more pronounced in women than men. Among the seven studies examining the relationship between frailty and sleep, four reported that higher Pittsburgh Sleep Quality Index (PSQI) scores were associated with an increased risk of frailty. Practical implications Most previous studies have focused on interventions targeting a single area such as muscle strength or exercise habits, in older adults at risk for frailty. The results suggest that interventions targeting improved sleep may positively impact the maintenance of muscle strength. Originality/value The literature review revealed that too much or too little sleep increases the risk of sarcopenia in older adults. Further, sleep deprivation, greater night-time wakefulness and reduced sleep quality increase the risk of frailty. Interestingly, the risk of mortality is increased in individuals with daytime functional disorders such as excessive drowsiness or napping habits.


2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Masamitsu Sugie ◽  
Kazumasa Harada ◽  
Tetsuya Takahashi ◽  
Marina Nara ◽  
Teruyuki Koyama ◽  
...  

Abstract Background: Frailty and sarcopenia are age-related morbid states, and a low body mass index (BMI) is a characteristic of frailty and cachexia. However, no common index for assessing these three muscle wasting states is available, making it difficult to understand the relationship among them. Peak oxygen uptake (peak VO2), an index of life expectancy, may be a useful common index. Therefore, this study aimed to investigate the relationship among sarcopenia, frailty, and cachexia using age, BMI, and peak VO2. Methods: Participants were 175 Japanese community dwelling older adults (58 men, 117 women; 77.6 years). We assessed biochemical, physiological, and physical factors, and symptoms associated with frailty, and cachexia. Peak VO2 was assessed with a cardiopulmonary exercise test. Participants were classified into five groups: robust, pre-frail, frail, sarcopenia, and cachexia. We compared the groups by age, BMI, and peakVO2 with average values and 95% confidence intervals (CIs).Results: 17% (n=30) of participants were classified as robust, 40% (n=70) as pre-frail, 12% (n=21) as sarcopenia, 25% (n=44) as frail, and 6% (n=10) as cachexia. Significant differences were found in age (robust vs. frail, pre-frail vs. frail), BMI (robust vs. cachexia, pre-frail vs. cachexia, frail vs. cachexia), and peak VO2 (robust vs. frail, robust vs. cachexia, pre-frail vs. cachexia) with average values and 95% CIs. Three dimensions among age, BMI and peak VO2 revealed two trajectories (from robust to frailty via pre-frailty, and from robust to cachexia via sarcopenia) among muscle wasting diseases.Conclusions: This study revealed two trajectories among muscle wasting diseases.


2015 ◽  
Vol 24 (2) ◽  
pp. 65-70
Author(s):  
JoAnne Robbins ◽  
Jackie Hind

This article discusses oropharyngeal strengthening for swallowing rehabilitation in adults. Reduced oropharyngeal strength is common in older adults and adults with age-related medical conditions resulting in less effective bolus transit and increased risk of aspiration. Specific information is presented regarding scientific and theoretical basis (past), development of devices to facilitate and evidence supporting oropharyngeal strengthening (present), and areas requiring further study (future).


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252208
Author(s):  
Liqun Wang ◽  
Jiangping Li ◽  
Zhizhong Wang ◽  
Yong Du ◽  
Ting Sun ◽  
...  

Background Studies have found that social capital (SC) is associated with the risk of cognitive decline; however, the mechanism explaining how SC leads to cognitive decline is unclear. The current study examines the mediation effect of sleep duration on the relationship between SC and cognitive decline in Chinese older adults. Methods A cross-sectional study of 955 community-dwelling aged 60 or over was conducted. The mini-mental state examination (MMSE), self-report sleep duration questionnaire, and social capital scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model. Results After controlling for covariates, both social cohesion and social interaction were positively correlated with the MMSE score (p<0.001), and social cohesion was negatively correlated with sleep duration (p = 0.009); On the contrary, sleep duration was negatively correlated with MMSE score (p<0.001). Linear regression analysis showed social cohesion was positively associated with the MMSE score (β = 0.16, p = 0.005), while sleep duration was associated with an increased risk of cognitive decline (β = -0.72, p<0.001). Sleep duration has mediated the relationship between social cohesion and cognitive decline (explaining 21.7% of the total variance). Conclusions Social capital negatively associated with the risk of cognitive decline in this Chinese population, and sleep duration may partly explain this relationship. It may be a suggestive clue to identify those at a higher risk of progressing to cognitive impairment. Further prospective study in need to confirm this finding due to the cross-sectional design.


2003 ◽  
Vol 11 (2) ◽  
pp. 167-188 ◽  
Author(s):  
Bradley D. Hatfield ◽  
Thomas W. Spalding ◽  
Ross J. Apparies ◽  
Amy J. Haufler ◽  
D. Laine Santa Maria

Latencies and peak-to-peak amplitudes of pattern-reversal evoked-potential (PREP) components of active and inactive community-dwelling healthy 61- to 77-year-olds were compared with those of active and inactive 18- to 31-year-olds to determine whether long-term physical activity involvement was associated with attenuation of age-related changes in sensory processes. Binocular PREPs were derived for each of 2 check sizes (22 × 15 ft and 41 × 30 ft of visual angle) to provide increasing challenge of spatial resolution. Analyses of the latencies revealed significant effects for age, gender, and check size such that latencies were longer for older than for young participants, men than for women, and small than for larger check sizes. Amplitudes were larger in older adults for the P100-N150 peak-to-peak difference, but physical activity history was not associated with reduction of the observed age-related increases in component latencies and amplitude. As such, physical activity does not appear to attenuate age-related decline in visual sensory processing.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 746-746
Author(s):  
Carrie Nieman ◽  
Jennifer Deal ◽  
Sara Czaja ◽  
Esther Oh

Abstract Age-related hearing loss is highly prevalent among persons with dementia (PwDs) and is associated with an increased risk of neuropsychiatric symptoms. However, few use hearing aids and disparities exist. PwDs and, in particular, minority older adults, have some of the lowest rates of hearing aid use. Recent federal legislation created the designation of over-the-counter hearing aids, which will debut by 2020-2021, and represents an opportunity to advance accessibility. This presentation will share estimates of hearing aid use among community-dwelling PwDs from two cohorts, where hearing aid use ranges from 7-11% among African Americans versus 33-45% among whites. To explore this gap, the presentation will share findings from semi-structured interviews with care partners of PwDs and hearing loss around barriers and facilitators of hearing care, including device usability. With growing understanding of sensory health, a changing hearing care landscape represents a critical opening to increase access to hearing care for PwDs. Part of a symposium sponsored by the Alzheimer’s Disease Research Interest Group.


2019 ◽  
Vol 34 (6) ◽  
pp. 1049-1049
Author(s):  
A Alioto ◽  
K Conde ◽  
M Salazar-Villanea ◽  
J Moncada-Jimenez ◽  
D Cahn-Weiner ◽  
...  

Abstract Objective There is evidence that cardiorespiratory fitness (CRF) protects against age-related declines in processing speed (PS), but studies investigating older adults living in low and middle-income countries are lacking. We used data from the Epidemiology and Development of Alzheimer’s Disease (EDAD) study to investigate the role of CRF on PS in older Costa Rican adults. Method 306 community dwelling older adults (mean age = 69) were recruited for a study on cognition and physical fitness. We used a regression model to test the association between CRF and a composite measure of PS (Digit Symbol, Trails A, Block Design, and Stroop Color Naming). Confirmatory factor analysis (CFA) with full information maximum likelihood was conducted in a nested multi-step process on subtest scores. We also compared the strength of the relationship between two measures of CRF: Maximal oxygen uptake (V02 peak) and a latent variable comprised of distance achieved during the 6-minute Walk Test and change in heart rate before and after walking (Modified 6-Minute Walk). Results Higher CRF was significantly associated with PS, and the association remained significant after controlling for age and sex (B = 0.21; p < .001). The strength of the relationship between two measures of CRF was very high, suggesting equivalence of these indices. Conclusions CRF and PS are clinically meaningful therapeutic targets for future prevention trials in Latin America. The modified 6-Minute Walk is an efficient approximation of the gold standard CRF measurement. The cognitive benefits of CRF should be compared to other lifestyle interventions (e.g., diet) to determine the active components of cognitive improvement.


Author(s):  
Jungmin LEE ◽  
Heuy Sun SUH ◽  
In Cheol HWANG

Background: Age-related macular degeneration (AMD) and cardiovascular disease (CVD) share pathogenic mechanisms, and their lead-lag relationship remains unclear. We performed a meta-analysis of data from longitudinal studies to evaluate the interactive association between age-related macular degeneration (AMD) and cardiovascular disease (CVD). Methods: A literature search was performed in PubMed, Embase, and Cochrane Library up to Feb 2019. Estimates were pooled by study quality and type of AMD and CVD. Publication bias was assessed by Begg’s test. Results: We identified nine studies for the risk of AMD in CVD and ten studies for the risk of CVD in AMD. Overall, evidence for the risk of CVD in AMD patients was most robust. Both early and late AMD preceded CVD, but more solid significance existed in late AMD. Among the types of CVD, stroke was more tightly associated with AMD than coronary heart disease. Publication bias was not significant in either direction. Conclusion: AMD is a risk factor for CVD, which is primarily driven by the increased risk of stroke in patients with late AMD. Moreover, these results suggested that AMD treatment and screening for CVD in AMD patients may have unexplored clinical benefits.


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