Geriatrik disfaji ve beslenme tedavisi

Yaşlı bireylerin, 2050 yılında gelişmiş ülkelerdeki nüfusun %25'ini oluşturacağı tahmin edilmektedir. Yaşlanmanın fizyolojisi ile birlikte yaşlı bireylerde disfaji, önemli bir sağlık sorunu olarak ortaya çıkabilmektedir. Disfaji, nöromüsküler bozukluk veya mekanik tıkanmadan kaynaklanabilen yutma güçlüğüdür. Malnütrisyon, dehidratasyon ve aspirasyon pnömonisi gibi birçok komplikasyonu da beraberinde getirmektedir. Son dönemde disfajinin, geriatrik sendrom olarak tanınmasına dair artan farkındalık mevcuttur. Yaşlılarda disfaji yaşlanmanın normal bir parçası olarak düşünüldüğü için fark edilmeyebilmektedir. Bu durumda hastalığın ilerlemesine ve beraberinde komplikasyonları getirmesine yol açmaktadır. Disfaji için doğru teşhis ve multidisipliner yaklaşım tedavide başarıyı getirmektedir. Yaşlılarda disfaji tedavisi için standart bir yaklaşım bulunmamaktadır. Disfaji tedavileri arasında duruş ayarlamaları, besin ve sıvı oranı-miktarı, diyet değişikliği, ağız sağlığı, yutma rehabilitasyonu ve farmakolojik tedavi gibi diğer yaklaşımlar yer almaktadır. Disfajide beslenme için dokusu değiştirilmiş diyetlerin kullanımı tavsiye edilmektedir. Tüm bakım ortamları için ve her yaştan disfajili bireyler tarafından kullanılan dokusu değiştirilmiş besinleri ve koyulaştırılmış sıvıları tanımlamak için Uluslararası Disfaji Diyet Standardizasyon Girişimi kurulmuştur. Bazı kılavuzlarda disfaji hastaları için beslenme önerileri mevcuttur. Ancak disfajide beslenme için netlik olmadığından bu derleme çalışma, geriatrik disfaji ve beslenme tedavisine ilişkin bilgileri sunmak amacıyla planlanmış ve yürütülmüştür.

Anahtar Kelimeler:

Beslenme Tedavisi, disfaji, geriatri

Geriatric dysphagia and nutritional therapy

It is estimated that elderly individuals will constitute 25% of the population in developed countries by 2050. Along with the physiology of aging, dysphagia can emerge as an important health problem in elderly individuals. Dysphagia is swallowing difficulty that may result from neuromuscular disorder or mechanical obstruction. It also brings many complications such as malnutrition, dehydration and aspiration pneumonia. Recently, there has been increasing awareness of the recognition of dysphagia as a geriatric syndrome. Dysphagia in the elderly may go unnoticed as it is considered a normal part of aging. In this case, it leads to the progression of the disease and to its complications. Accurate diagnosis and multidisciplinary approach for dysphagia bring success in treatment. There is no standard approach for the treatment of dysphagia in the elderly. Dysphagia treatments include posture adjustments, nutrient and fluid ratio-amount, diet change, oral health, swallowing rehabilitation, and other approaches such as pharmacological treatment. The use of tissue modified diets is recommended for nutrition in dysphagia. The International Dysphagia Dietary Standardization Initiative was established to define tissue-modified foods and thickened fluids used for all care settings and by individuals of all ages with dysphagia. Some guidelines have nutritional recommendations for patients with dysphagia. However, since there is no certainness for nutrition in dysphagia, this review study was planned and conducted to present information on geriatric dysphagia and nutritional therapy.

Keywords:

Nutrition therapy, dysphagia, geriatrics,

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