Sarcopanic Dysphagia, Swallowing Disorder
Conditions
Keywords
Prevention, Nutrition, Re-education
Brief summary
Sarcopenic dysphagia is described as a swallowing disorder caused by a loss of muscle mass and strength, sarcopenia. It induces chronic complications like micro-inhalations and the worsening of chronic undernutrition, according to a vicious circle. Awareness of the high prevalence of sarcopenic dysphagia and its serious consequences among elderly people with disabilities and hospitalized patients is recent, which explains the low rate of screening in the population concerned. In this context, methods of prevention, evaluation and intervention of sarcopenic dysphagia adapted to the most exposed population are needed. Two European learned societies have developed recommendations that include increased awareness of swallowing disorders, the use of screening scores, preventive measures, diagnostic standardization, and implemented interventions (rehabilitation, textural adaptation, etc.). In order to respect these recommendations, a pedagogical sheet, entitled DYSPHAGING was elaborated within our unit in a multiprofessional way in 4 steps (1 - Screen; 2 - Protect; 3 - Confirm; 4 - Rehabilitate). This feasibility study aims to evaluate the rate of completion and the conditions for implementing steps 1 and 2 in hospital and institutional care units.
Detailed description
Sarcopenic dysphagia is described as a swallowing disorder caused by a loss of muscle mass and strength, sarcopenia. It induces chronic complications like micro-inhalations and the worsening of chronic undernutrition, according to a vicious circle. Awareness of the high prevalence of sarcopenic dysphagia and its serious consequences among elderly people with disabilities and hospitalized patients is recent, which explains the low rate of screening in the population concerned. In this context, methods of prevention, evaluation and intervention of sarcopenic dysphagia adapted to the most exposed population are needed. Two European learned societies have developed recommendations that include increased awareness of swallowing disorders, the use of screening scores, preventive measures, diagnostic standardization, and implemented interventions (rehabilitation, textural adaptation, etc.). In order to respect these recommendations, a pedagogical sheet, entitled DYSPHAGING was elaborated within our unit in a multiprofessional way in 4 steps (1 - Screen; 2 - Protect; 3 - Confirm; 4 - Rehabilitate). This feasibility study aims to evaluate the rate of completion and the conditions for implementing steps 1 and 2 in hospital and institutional care units.
Interventions
OTHEREAT-10 (Eating assessment Tool) screening questionnaire
After inclusion, issuance of the EAT-10 screening questionnaire for swallowing disorders by the healthcare team
PROCEDUREProtective measures for the upper airways
In the event of an EAT ≥2 score, immediate implementation or within three days by the healthcare team of protective measures for the upper airways in 3 sectors: 1: Postural maneuvers; 2: Hygienodietetic rules; 3: Food textures
Sponsors
Hospices Civils de Lyon
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patient aged ≥ 70 years, * Patient affiliated to a social security system, * Patient hospitalized in the health sector or in a medico-social institute, * Patient informed of the study (information leaflet provided) and having orally signified their consent to inclusion in the study. * Patient under legal protection, guardianship or curatorship,
Exclusion criteria
* Patient unable to feed orally, * Patient with an active pathology responsible for acute swallowing disorders (\< 3 months) (neurodegenerative pathology with predominant motor impairment such as Charcot's disease, stroke, ENT disease). * Patient unable to answer the questionnaire.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of complete achievement of steps 1 and 2 | Three days | The judgment criterion is validated if 1. Stage 1 is performed and the EAT-10 \< 2 or if 2. Stage 1 is performed with an EAT-10 ≥ 2 and stage 2 is performed within 3 days after stage 1 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Age, gender, comorbidities (CIRS-G), autonomy (ADL, IADL), co-medications | 19 months | Patient characteristics will be collected at each site at the end of the study by a clinical research assistant based on their medical records. |
| Rate of partial completion of the protocol | 19 months | Proportion of non-performance of step 1 and/or step 2 within the time limit. Proportion of steps 2 carried out incompletely), description of the reasons |
| Percentage of eligible patients refusing to participate in the study | 18 months | Number of eligible patients who refused to participate in the study |
| Composition and disciplines of the care team | 19 months | At the end of the study, all data on the each allied health professionals will be collected on the dysphaging sheet |
| Caregiver satisfaction (Likert scale). | 19 months | At the end of the study, each allied health professionals who has been involved in the care of at least one patient will fill out a satisfaction questionnaire. |
| Diagnosis of undernutrition and/or neurocognitive disorders and/or patent lung infection and/or COPD described in the patient's medical file, nutritional risk situation assessed by the Mini Nutritional Assessment® (MNA) | 19 months | Patient characteristics will be collected at each site at the end of the study by a clinical research assistant based on their medical records. |
Countries
France
Contacts
Primary ContactMarion MERDINIAN, Dr
Backup ContactClaire FALANDRY, Pr
Outcome results
None listed