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Oropharyngeal dysphagia and nutritional status in the elderly

Oropharyngeal dysphagia (OD) can lead to an antioxidant micronutrient deficiency. A recent study (Homem SG, et al., Clin Nutr ESPEN. 2020 Aug;38:211-217. doi: 10.1016/j.clnesp.2020.04.011) investigated this in the elderly, with respect to antioxidant vitamins (β-carotene, vitamin E and C) and serum markers of inflammatory response (C-reactive protein, myeloperoxidase (MPO), nitric oxide metabolites (NOx), tumor necrosis factor-α, interleukin (IL)-1β and IL-6).

It was a cross-sectional study of 69 individuals: 22 in the control group (CG) and 47 in the OD group (ODG). The ODG was subdivided into ODG-mild = normal oral feeding (OF, n = 14), ODG-moderate (OF-modified, n = 22) and ODG-severe (OF-suspended, n = 11).

Body mass index (BMI), a marker for general nutritional status, was higher in the ODG than in the CG (p = 0.008), independent of sex, age, energy intake (EI) and score on the Functional Independence Measure. OD associated with lower concentrations of β-carotene (p < 0.001) and vitamin C (p < 0.001), independent of sex, age and EI, and higher concentrations of MPO (p = 0.008) and NOx (p = 0.011), independently of sex, age and the presence of comorbidities.

Thus, older adults with OD have lower levels of two antioxidant vitamins, and a high inflammatory response. In other posts we have observed that lower levels of NO are a direct consequence of non-nasal breathing. This study shows that lower NO levels can go with swallowing disorders too.

MyoNews from BreatheWorksTM is a report on trends and developments in oromyofunctional disorder and therapy. These updates are not intended as diagnosis, treatment, cure or prevention of any disease or syndrome.

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