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探索老年人吞咽困难与健康相关结局之间的关联:伊尔西伦特研究结果

Exploring the Associations Between Dysphagia and Health-Related Outcomes in Older Adults: Results from the ilSirente Study.

作者信息

Coelho-Júnior Hélio José, Álvarez-Bustos Alejandro, Pérez Ramírez Cristina, Russo Andrea, Rodriguez-Mañas Leocadio, Landi Francesco, Marzetti Emanuele

机构信息

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.

Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy.

出版信息

Nutrients. 2025 Jun 28;17(13):2149. doi: 10.3390/nu17132149.

Abstract

The present study examined cross-sectional and longitudinal associations between dysphagia and a variety of health-related parameters, including physical performance, cognitive function, malnutrition, sarcopenia, disability, frailty, falls, hospitalization, and mortality in a cohort of octogenarians living in the mountainous Sirente region of Central Italy. Dysphagia was operationalized as the need to modify the diet to facilitate swallowing and/or the exclusive consumption of specific food consistencies due to swallowing difficulties. Physical performance, cognitive function, malnutrition, disability, falls, and hospitalizations were assessed via the Minimum Data Set for Home Care. Sarcopenia was defined as the coexistence of low muscle mass and dynapenia, while frailty was operationalized according to Fried's phenotype. History of falls and incident falls, as well as disability, were tracked over two years, while survival status was followed for up to ten years. Data of 362 older adults (men age: 85.9 ± 4.8; body mass index: 25.6 ± 4.53; women: 66.9%; multimorbidity: 21.5%; dysphagia: 6.6%) were analyzed. The results indicated that dysphagia was significantly and cross-sectionally associated with poor physical performance and reduced cognitive function. In contrast, no longitudinal associations were observed. Dysphagia appears to be linked to deficits in physical and cognitive domains, underscoring the value of comprehensive geriatric assessment and the development of multidomain intervention strategies.

摘要

本研究调查了意大利中部锡伦特山区一群八旬老人吞咽困难与各种健康相关参数之间的横断面和纵向关联,这些参数包括身体机能、认知功能、营养不良、肌肉减少症、残疾、衰弱、跌倒、住院和死亡率。吞咽困难的定义是因吞咽困难而需要调整饮食以促进吞咽和/或只能食用特定质地的食物。通过家庭护理最小数据集评估身体机能、认知功能、营养不良、残疾、跌倒和住院情况。肌肉减少症定义为低肌肉量和肌肉力量减弱同时存在,而衰弱则根据弗里德表型来定义。对跌倒史和新发跌倒以及残疾情况进行了为期两年的跟踪,对生存状况进行了长达十年的随访。分析了362名老年人的数据(男性年龄:85.9±4.8;体重指数:25.6±4.53;女性:66.9%;多种疾病:21.5%;吞咽困难:6.6%)。结果表明,吞咽困难与身体机能差和认知功能下降存在显著的横断面关联。相比之下,未观察到纵向关联。吞咽困难似乎与身体和认知领域的缺陷有关,这凸显了综合老年评估的价值以及多领域干预策略的制定。

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本文引用的文献

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Association between malnutrition and negative health outcomes in Italian older adults: findings from the ilSIRENTE study.
Front Nutr. 2025 Jun 4;12:1585310. doi: 10.3389/fnut.2025.1585310. eCollection 2025.
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