Theme lead
Senior Researcher Tina Hansen, PhD, MSc.OT
Background
Sarcopenic dysphagia is swallowing difficulty due to loss of mass and function of whole-body skeletal and swallowing muscles, which is often found in older patients with multi-morbidity. Sarcopenic dysphagia is caused by normal age-related changes of the swallowing mechanism in conjunction with iatrogenic sarcopenia due to inactivity, malnutrition, and/or disease status. Multidisciplinary rehabilitation nutrition aims to prevent or treat both iatrogenic sarcopenia and sarcopenic dysphagia, and encompasses 'nutrition care management in consideration of rehabilitation' and 'rehabilitation in consideration of nutrition'. This is implemented by an evidence-based rehabilitation nutrition care process that involves assessment, goal setting, intervention, and monitoring.
Focus
We want to understand if and how 'rehabilitation in consideration of nutrition' can prevent and/or improve sarcopenic dysphagia in the rehabilitation nutrition care process during acute hospitalization and after discharge to the municipality. We are particularly interested in how we can prevent or improve activity-related iatrogenic sarcopenia of the swallowing mechanism. We investigate different assessment approaches as well as how motor learning theories, strength training principles, and skill training are best integrated into interventions targeting the swallowing musculature. To ensure intervention implementation, we are concerned with intervention feasibility in terms of tolerance, usefulness, and acceptability by the target group, as well as determinants for delivery of the intervention.
Examples of ongoing work
A Danish occupational therapy initiative, the ACTING (ACTivity-based Skill Training of INGestion) programme, was developed to challenge and improve ingestion functions that have declined due to age-related changes, with the aim of achieving sustained improvements in both ingestive skills and underlying physiological function.
ACTING applies an occupation-based approach, using direct engagement in meaningful eating and drinking activities as the therapeutic medium. Through shared decision-making and collaborative goal setting, occupational therapists provide graded, purposeful, and contextually relevant mealtime tasks to support safe, efficient, and engaging meal participation.
Research on ACTING follows the British Medical Research Council (MRC) framework for the development and evaluation of complex interventions through an iterative, multi-phase process. Following completed feasibility and proof-of-concept studies, current work focuses on planning a pilot randomised controlled trial as a preparatory step toward a future large-scale effectiveness evaluation.
Selected outputs
Hansen T, Andersen U, Takeuchi Holm M, Wæhrens EE. Occupation-centred intervention for age-related dysphagia: A proof-of-concept study. Scandinavian journal of occupational therapy. 2025;32(1):2620346. doi:10.1080/11038128.2026.2620346.
Hansen T, Staal SM, Rauhe Harreby ND, Andersen U, Holm MT, von Bülow C, Wæhrens EE. Task-Based Eating and Drinking Interventions in Animal Models: A Narrative Review of Functional Improvements and Neuromuscular Adaptations in Age-Related Dysphagia. Geriatrics. 2024; 9(6):138. https://doi.org/10.3390/geriatrics9060138.
Hansen T,
Laursen, LB, Hansen
MS. Early Feasibility of an Activity-Based
Intervention for Improving
Ingestive Functions in Older
Adults with Oropharyngeal Dysphagia.
Geriatrics 2023, 8, 44. https://doi.org/10.3390/geriatrics8020044
Hansen T, Rasmussen SAF, Fabricius J, Grove LD, Simpelaere I. Measuring mealtime performance in older adults with suspected oropharyngeal dysphagia: an updated systematic review of psychometric properties [published online ahead of print, 2023 Feb 15]. Disability and rehabilitation. 2023;1-15. doi:10.1080/09638288.2023.2178033
Hansen T, Nielsen RL, Houlind MB, et al. Dysphagia Prevalence, Time Course, and Association with Probable Sarcopenia, Inactivity, Malnutrition, and Disease Status in Older Patients Admitted to an Emergency Department: A Secondary Analysis of Cohort Study Data. Geriatrics (Basel). 2021;6(2):46. doi:10.3390/geriatrics6020046
Hansen T, Thomassen JM, Jensen LE, et al. Development of an Intervention for Improving Ingestion in Elders with Oropharyngeal Dysphagia, Physical & Occupational Therapy In Geriatrics. 2021;39:1, 70-95, DOI: 10.1080/02703181.2020.1800159