Ann Rehabil Med.  2023 Oct;47(5):337-347. 10.5535/arm.23101.

Sarcopenic Dysphagia and Simplified Rehabilitation Nutrition Care Process: An Update

• Kakehi S
• Isono E
• Wakabayashi H
• Shioya M
• Ninomiya J
• Aoyama Y
• Murai R
• Sato Y
• Takemura R
• Mori A
• Masumura K
• Suzuki B

• KMID: 2548393
• DOI: http://doi.org/10.5535/arm.23101

Abstract

Sarcopenic dysphagia is characterized by weakness of swallowing-related muscles associated with whole-body sarcopenia. As the number of patients with sarcopenia increases with the aging of the world, the number of patients with sarcopenic dysphagia is also increasing. The prevalence of sarcopenic dysphagia is high in the institutionalized older people and in patients hospitalized for pneumonia with dysphagia in acute care hospitals. Prevention, early detection and intervention of sarcopenic dysphagia with rehabilitation nutrition are essential. The diagnosis of sarcopenic dysphagia is based on skeletal and swallowing muscle strength and muscle mass. A reliable and validated diagnostic algorithm for sarcopenic dysphagia is used. Sarcopenic dysphagia is associated with malnutrition, which leads to mortality and Activities of Daily Living (ADL) decline. The rehabilitation nutrition approach improves swallowing function, nutrition status, and ADL. A combination of aggressive nutrition therapy to improve nutrition status, dysphagia rehabilitation, physical therapy, and other interventions can be effective for sarcopenic dysphagia. The rehabilitation nutrition care process is used to assess and problem solve the patient’s pathology, sarcopenia, and nutrition status. The simplified rehabilitation nutrition care process consists of a nutrition cycle and a rehabilitation cycle, each with five steps: assessment, diagnosis, goal setting, intervention, and monitoring. Nutrition professionals and teams implement the nutrition cycle. Rehabilitation professionals and teams implement the rehabilitation cycle. Both cycles should be done simultaneously. The nutrition diagnosis of undernutrition, overnutrition/obesity, sarcopenia, and goal setting of rehabilitation and body weight are implemented collaboratively.

Keyword

Aging; Deglutition disorders; Frailty; Muscles; Sarcopenia

Figure

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  Fig. 1. Diagnostic flowchart of sarcopenic dysphagia. HS, hand grip strength; GS, gait speed; DXA, dual-energy X-ray absorptiometry; BIA, bioelectrical impedance analysis.

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  Fig. 2. Simplified rehabilitation nutrition care process.

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