Elderly People With Alzheimer’s Disease Are At Risk for Swallowing Dysfunction

PERTH, Australia -- April 22, 2015 -- People with Alzheimer’s disease (AD) may have muscle tissue loss and swallowing problems that need treatment, according to a study presented here at the 30th International Conference of Alzheimer’s Disease International (ADI).

 

The results of the study suggest that treatment of swallowing dysfunction is important for sarcopenia prevention in elderly people with AD. Yutaka Watanabe, PhD, DDS, Department of Oral Diseases Research, National Center for Geriatrics and Gerontology, Obu, Japan, and colleagues presented the study on April 16.

 

Sarcopenia, measured by Skeletal Muscle Index (SMI), is a risk factor for a decline in the activities of daily living (ADL) among the elderly, and secondary sarcopenia may be caused by factors other than aging, such as malnutrition or chronic illness, including dementia.

 

To investigate the risk factors of appendicular skeletal muscle mass decline in elderly people with AD and focus on oral function, Dr. Watanabe and colleagues studied 232 elderly patients with AD in 2 prefectures in Japan. The average age of the 201 women and 31 men was 85.4 years.

 

All of the participants underwent SMI measurement with the InBodyS10 body water analysis device for monitoring nutritional status (InBody Co., Ltd., Seoul, South Korea) and were evaluated with the Mini-Nutrition Assessment short form, clinical dementia rating (CDR), and Barthel index of ADL. They were tested for eating and swallowing function, occlusal contacts, tongue function, and swallowing function. The participants also completed a survey of basic information.

 

The lowest 25th percentile was determined via multivariate analysis, SMI cut-off values were set for women and men, and logistic regression was used to investigate factors related to SMI.

 

The researchers created 3 models that gave them statistically significant results. In model 1, with all variables controlled, the changes in Barthel index and swallowing function were significant, with both having an odds ratio (OR) of 15.2. Model 2, which had independent variables controlled for basic information, AD severity, oral status, oral function, and swallowing function, showed a change to severe CDR (OR = 30.3) and swallowing function (OR = 12.8) In model 3, with independent variables controlled for basic information and AD severity, there was a significant change to severe CDR (OR = 47.0).

 

“Greater SMI declines were seen in groups with increasing AD severity. Swallowing function, ADL decline, and dementia severity were significantly associated with SMI decline in elderly people with AD,” concluded the researchers.

 

[Presentation title: Risk Factors for Appendicular Skeletal Muscle Mass Decline in Elderly People With Alzheimer’s Disease: Focus on Swallowing Function. Abstract P079]

 

By Lorraine L. Janeczko