Evaluation and standardized dietary strategies for dysphagia in older adults: a narrative review

老年人吞咽困难的评估和标准化饮食策略:一项叙述性综述

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Abstract

OBJECTIVES: This review aimed to elucidate the characteristics of dysphagia and age-related swallowing changes (presbyphagia) in older adults and to comprehensively examine assessment tools and standardized meal management strategies applicable in community settings to propose effective meal management strategies for healthy longevity. METHODS: Domestic and international literatures were analyzed regarding the definition and causes of dysphagia, physiological and structural characteristics and clinical impacts of presbyphagia, assessment and diagnostic tools Korea version of EAT-10 (K-EAT-10) and Korea version of Dysphagia Risk Assessment for the Community-dwelling Elderly (K-DRACE), and the International Dysphagia Diet Standardization Initiative (IDDSI). RESULTS: Dysphagia compromises safe swallowing and nutritional intake in older adults, leading to serious complications, such as aspiration pneumonia, dehydration, malnutrition, sarcopenia, and reduced quality of life. The K-EAT-10 and K-DRACE proved effective for rapid screening of dysphagia risk in community-dwelling older adults. Moreover, texture-modified meals and viscosity adjustments based on the IDDSI standards are useful for reducing the risk of aspiration and improving nutrient intake. Meals can be classified as liquidized, minced, chopped, or regular, allowing for individualized management. CONCLUSION: Presbyphagia is a multidimensional problem, and the integrated use of assessment tools and standardized meals is crucial. Community-based dysphagia management programs and collaboration among dietitians and healthcare professionals are needed to improve the nutritional status and quality of life of older adults.

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