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      Dysphagia and its relation with nutritional status and calorie/protein intake in the elderly Translated title: Disfagia e sua relação com o estado nutricional e ingestão calórico-proteica em idosos

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          Abstract

          ABSTRACT Purpose: to evaluate the nutritional status associated with dysphagia, and compare the calorie and protein intake of dysphagic elderly patients to that of non dysphagic ones, during hospitalization. Methods: this is a cross-sectional study with elderly people ranging from 60 to 80 years old admitted as inpatients in a medical and neurological clinic of a public hospital. They formed two groups, according to the presence of dysphagia: dysphagic and non dysphagic ones. The inclusion criteria were: dysphagia secondary to stroke and exclusive oral feeding. Anthropometric measurements and the Mini-Nutritional Assessment (MNA) were applied. The 24-hour recall was used to analyze food consumption. The statistical analysis used the Fisher's exact test for the association of variables, and the Mann-Whitney test, for their comparison. Results: a total of 12 elderly people participated, whose mean age was 70.50 ± 7.77 years in the dysphagia group (n = 6), and 72.67 ± 5.01 years in the non dysphagia group (n = 6).There was an association between the presence of dysphagia and the risk of malnutrition, according to MNA (p = 0.028). No significant difference in calorie and protein intake was seen between the groups. The group with dysphagia had a lower water intake as compared to the non dysphagia group (p = 0.045). Conclusion: dysphagia was associated with the risk of malnutrition and lower fluid intake in dysphagic patients, thus, increasing their risk of dehydration.

          Translated abstract

          RESUMO Objetivo: avaliar o estado nutricional associando-o à disfagia e comparar a ingestão calórico-proteica de idosos disfágicos e não disfágicos durante internação hospitalar. Métodos: estudo transversal, realizado com idosos de 60 a 80 anos admitidos nas enfermarias de clínica médica e neurológica de um hospital público, compondo-se dois grupos pela presença de disfagia: idosos disfágicos e não-disfágicos. Os critérios de inclusão foram: disfagia secundária a acidente vascular encefálico e alimentação oral exclusiva. Foram realizadas medidas antropométricas e aplicada a miniavaliação nutricional (MAN). O recordatório de 24h foi utilizado para análise do consumo alimentar. Na análise estatística foram utilizados o Teste Exato de Fisher para associação e Teste de Mann Whitney para comparação das variáveis. Resultados: participaram 12 idosos, média da idade de 70,50± 7,77 anos no grupo disfágico (n=6) e 72,67± 5,01 anos no grupo não-disfágico (n=6). Houve uma associação entre a presença de disfagia e risco de desnutrição pela MAN (p=0.028). Não houve diferença significante quanto à ingestão calórica e proteica entre os grupos. O grupo disfágico apresentou ingestão hídrica inferior em relação ao grupo não disfágico (p=0.045). Conclusão: a disfagia foi associada ao risco de desnutrição e à menor ingestão de líquidos em pacientes disfágicos, aumentando o risco de desidratação.

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          Most cited references35

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          Screening for nutritional status in the elderly.

          A comprehensive assessment of nutritional status is a critically important component of any patient evaluation. Based upon clinical information, anthropometric data, and a small number of laboratory investigations, an accurate appraisal of nutritional status should be possible and an appropriate intervention plan can be developed. The actual approach depends on the particular problem discovered. These are discussed in detail elsewhere in this issue.
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            Estimating stature from knee height for persons 60 to 90 years of age.

            Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in the nonambulatory elderly person, or its value may be spurious if measured in those elderly persons with excessive spinal curvature. Simple equations are presented for estimating the stature of elderly men from a recumbent measure of knee height and for elderly women from a recumbent measure of knee height and age. The 90 per cent error bounds for these equations for an individual are about plus or minus 6.0 cm. Knee height is highly correlated with stature.
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              ESPEN guideline clinical nutrition in neurology.

              Neurological diseases are frequently associated with swallowing disorders and malnutrition. Moreover, patients with neurological diseases are at increased risk of micronutrient deficiency and dehydration. On the other hand, nutritional factors may be involved in the pathogenesis of neurological diseases. Multiple causes for the development of malnutrition in patients with neurological diseases are known including oropharyngeal dysphagia, impaired consciousness, perception deficits, cognitive dysfunction, and increased needs. The present evidence- and consensus-based guideline addresses clinical questions on best medical nutrition therapy in patients with neurological diseases. Among them, management of oropharyngeal dysphagia plays a pivotal role. The guideline has been written by a multidisciplinary team and offers 88 recommendations for use in clinical practice for amyotrophic lateral sclerosis, Parkinson's disease, stroke and multiple sclerosis.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rcefac
                Revista CEFAC
                Rev. CEFAC
                ABRAMO Associação Brasileira de Motricidade Orofacial (São Paulo, SP, Brazil )
                1516-1846
                1982-0216
                2019
                : 21
                : 3
                : e15618
                Affiliations
                [1] Recife Pernambuco orgnameHospital dos Servidores do Estado orgdiv1Programa de Residência em Nutrição Clínica Brasil
                [3] Recife Pernambuco orgnameUniversidade Federal de Pernambuco orgdiv1Departamento de Fonoaudiologia Brazil
                [2] Vitória de Santo Antão Pernambuco orgnameUniversidade Federal de Pernambuco orgdiv1Centro Acadêmico de Vitória de Santo Antão orgdiv2Núcleo de Nutrição Brazil
                Article
                S1516-18462019000300401
                10.1590/1982-0216/201921315618
                798c18dc-d57f-4f40-8af9-bea4dd7e9ec3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 09 October 2019
                : 13 December 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 43, Pages: 0
                Product

                SciELO Brazil

                Categories
                Brief Communication

                Swallowing Disorders,Stroke,Nutritional Assessment,Food Intake,Aging,Transtornos de Deglutição,Acidente Vascular Cerebral,Avaliação Nutricional,Ingestão de Alimentos,Envelhecimento

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