Sarcopenic Dysphagia and Multimorbidity

​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

Feasibility and Impact of an Activity-based Intervention for Strengthening Ingestive Functions in Elders with Sarcopenic Dysphagia: A Multiple-case Study (ClinicalTrials.gov Identifier: NCT05269758).

Performance-based outcome measurement instruments to assess ingestion and mealtime functions in older adults with oropharyngeal dysphagia: An updated systematic review of psychometric properties using COSMIN methodology (PROSPERO ID 309662. Submitted 09/02/2022).​

Selected outputs

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

Hansen T & Kristiansen DM | Schumacher U (Reviewing Editor). Revisiting the psychometric properties of a revised Danish version of the McGill ingestive skills assessment, Cogent Medicine. 2017;4:1, DOI: 10.1080/2331205X.2017.1281558​

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