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REVIEW ARTICLES

Dysphagia in Individuals with Dementia
Demanslı Bireylerde Disfaji
Received Date : 27 Oct 2021
Accepted Date : 19 Nov 2021
Available Online : 08 Dec 2021
Doi: 10.24179/kbbbbc.2021-86783 - Makale Dili: TR
KBB ve BBC Dergisi. 2022;30(2):88-96
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Dementia; affecting memory, thinking, behavior, and ability to perform activities of daily living; it is a syndrome caused by many diseases. There are 47.5 million people with dementia in the world and this number is expected to increase to 75.6 million in 2030 and 135.5 million in 2050. During the progression of the disease, dysphagia, defined as swallowing difficulty, which occurs as a result of the swallowing mechanism being affected as a result of motor, sensory and behavioural problems or a combination of these, can be seen in these patients. The type, severity, and assessment method of dementia affect the prevalence results of dysphagia. Dysphagia can have many negative consequences such as decreased appetite, weight loss, fluid loss, malnutrition, regression in the quality of life with a fear of eating and drinking, recurrent lung infections, aspiration, and pneumonia. Aspiration pneumonia is the most common cause of death, especially in Alzheimer's dementia patients. However, dysphagia can be overlooked in individuals with dementia, as cognitive and behavioural disorders are emphasized. Therefore, individuals with dementia should be evaluated early in terms of detailed dysphagia and personalized dysphagia treatment should be applied with necessary preventive measures. In addition, families and caregivers of patients should be informed about dysphagia and aspiration symptoms. Thus, complications can be avoided, quality of life can be increased and mortality rates can be reduced. In this study, literature studies on the prevalence, etiology, evaluation, and treatment strategies of dementia were reviewed.
ÖZET
Demans; hafıza, düşünce, davranış ve günlük yaşam aktivitelerini yapma yeteneğini etkileyen, birçok hastalığın sebep olduğu bir sendromdur. Dünyanda 47,5 milyon demanslı birey bulunmaktadır ve bu sayının 2030'da 75,6 milyona ve 2050’de 135,5 milyona çıkması beklenmektedir. Bu hastalarda, hastalığın progresyonu sırasında motor, duyu, davranışsal problemlerin veya bunların kombinasyonunun bir sonucu olarak yutma mekanizmasının etkilenmesi ile oluşan ve yutma güçlüğü olarak tanımlanan disfaji görülebilmektedir. Demansta disfaji prevelansına yönelik çalışmalardaki sonuçlar farklılık göstermektedir. Demansın tipi, şiddeti ve değerlendirme yöntemi disfajinin prevelans sonuçlarını etkilemektedir. Disfajinin iştah azalması, kilo kaybı, sıvı kaybı, malnutrisyon, yeme-içme korkusuyla birlikte yaşam kalitesinde gerileme, tekrarlayıcı akciğer enfeksiyonları, aspirasyon ve pnömoni gibi birçok olumsuz sonucu olabilmektedir. Özellikle Alzheimer tip demans hastalarının en yaygın ölüm nedeni aspirasyon pnömonisidir. Fakat demanslı bireylerde, daha çok bilişsel ve davranışsal bozuklukların üzerinde durulduğu için disfaji gözden kaçabilmektedir. Bu yüzden demanslı bireyler, disfaji açısından erkenden ayrıntılı olarak değerlendirilmeli ve gerekli koruyucu önlemler ile kişiye özgü disfaji tedavisi uygulanmalıdır. Ayrıca hastaların aileleri, bakıcıları da disfaji, aspirasyon belirtileri konusunda bilgilendirilmelidir. Böylelikle komplikasyonlardan kaçınılabilir, yaşam kalitesi artırılabilir ve ölüm oranları azaltılabilir. Bu derlemede, demansın prevalansı, etiyolojisi, yutma değerlendirmesi ve disfaji tedavisine ait literatür çalışmaları incelenmiştir.
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