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
Mümüne Merve PARLAKa, Esma ALTANb, Güleser SAYLAMb
aHacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Dil ve Konuşma Terapisi Bölümü, Ankara, TÜRKİYE
bSağlık Bilimleri Üniversitesi Dışkapı Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları ABD, Ankara, TÜRKİYE
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.
Keywords: Dementia; deglutition disorders; deglutition
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.
Anahtar Kelimeler: Demans; yutma bozuklukları; yutma
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