嚥下障害が高齢者の栄養状態および食事形態に及ぼす影響について

Effect of Dysphagia on the Older Adults' Nutritional Status and Meal Pattern.

抄録

はじめに／目的:

嚥下障害は、高齢者に広くみられる臨床症状である。栄養状態や脱水の危険因子として知られているが、嚥下障害は食事形態にも影響を及ぼす。本研究は、高齢者における嚥下困難と低栄養の関係、および食事摂取パターンを明らかにすることを目的とした。

INTRODUCTION/OBJECTIVES: Dysphagia is a widespread clinical condition among older adults. Although known as a risk factor for nutritional status and dehydration, dysphagia also affects meal patterns. This study aimed to determine the relationship between dysphagia and undernutrition, as well as dietary consumption patterns in older adults.

方法:

268人の高齢者（女性144人、男性124人）を研究に組み入れた。データ収集には、ミニ栄養評価（MNA）、嚥下障害評価（EAT-10）、口腔内検査、半定量的食物摂取頻度調査（SFFQ）を使用した。オッズ比とカイ二乗法を用いて、低栄養の有無、食感改良食と非食感改良食の摂取者の独立変数を比較した。

METHODS: 268 older adults (144 women, 124 men) were included in the study. Mini Nutritional Assessment (MNA), dysphagia assessment (EAT-10), oral examination, and Semi-quantitative Food Frequency Questionnaire (SFFQ) were used for collecting data. Odds ratio and Chi square were used to compare independent variables in subjects with and without undernutrition as well as those who intake texture modified and non-texture modified diet.

結果:

低栄養群と通常栄養群の平均年齢はそれぞれ68.9±6.1歳および68.8±6.0歳であった。栄養不足群の日常生活動作（ADL）は19.7±0.9、通常栄養群は19.8±0.7であった。嚥下障害のある高齢者は、嚥下障害のない高齢者に比べて栄養不足になる可能性が4.8倍高かった（95％CI＝1.75-13.13、＝0.002）。嚥下障害高齢者群と正常嚥下高齢者群の食事パターンには、.05の水準で統計的な差異があった。

RESULTS: Mean age of the undernutrition and normal nutrition groups was 68.9 ± 6.1 and 68.8 ± 6.0 years, respectively. The undernutrition group's activities of daily living (ADL) were 19.7 ± 0.9, and the normal nutrition group was 19.8 ± 0.7. Older adults with dysphagia were 4.8 times more likely to experience undernutrition than older adults without dysphagia (95% CI = 1.75-13.13,  = .002). There was a statistically difference between the meal patterns among the dysphagic older adult group and the normal-swallowing older adults' group at the .05 level.

結論:

本研究によると、嚥下障害は高齢者の栄養状態および食事パターンに関連していた。本研究の結果は，高齢者の食事摂取や食事パターンに関連した口腔ケアについて，歯科医療従事者にいくつかの提言を示唆するものであった．

CONCLUSIONS: According to this study, dysphagia was associated with the nutritional status of older adults and dietary patterns. The study results suggested some recommendations for dental health personnel on oral care related to dietary consumption and dietary patterns in older adults.