Dissertação
Deglutição e aspectos nutricionais em idosos institucionalizados
Fecha
2022-10-14Autor
Genehr, Simone de Souza
Institución
Resumen
The aging process is the period of accentuation of morphophysiological limitations,
which can predispose the individual to a state of greater vulnerability to pathologies
and diseases, compromising the quality of life. In this sense, the epidemiological profile
of the elderly population is characterized by multiple comorbidities, polypharmacy, and
a high prevalence of mortality and morbidity, all resulting from conditions of
exacerbation by the chronic disease. Additionally, alterations in the swallowing function
can compromise the nutritional status and negatively affect the health conditions and
life expectancy of the elderly. The objective of the present study was to evaluate and
relate the characteristics of swallowing, nutritional and hematological status in
institutionalized elderly people, in addition to comparing the groups according to life
estimation scores. This is a cross-sectional, analytical, observational, uncontrolled
study with 13 elderly people living in a long-stay institution (ILPI). Nutritional
assessment was performed by measuring electrical bioimpedance, measurement of
abdominal, calf, and arm circumferences, and measurement of the subscapular
crease. Complementing the anthropometric measurements, a mini nutritional
assessment (MNA®) was performed. To assess the muscle strength of the elderly, the
hand grip strength test was performed. To assess swallowing, the speech therapy
protocol for risk assessment for dysphagia (PARD) and the Eating Assessment Tool
(EAT-10) were used. Finally, life expectancy was calculated using the age modified
Charlson Comorbidity Index (ICCI). As a result, they were stratified into two groups by
ICCI. In the group with high risk of mortality (n=8), overweight was highlighted in 5
(62.5%); cardiovascular risk in 4 (50%); malnutrition in 4 (50%) and risk for dysphagia
in 3 (37.5%). While in the group with the lowest risk of mortality (n=5), 4 were
overweight (80.0%); cardiovascular risk in 4 (80.0%); malnutrition in 1 (20.0%), and
risk for dysphagia in 4 (80.0%), in addition, there were no statistical differences
between the groups. Dynapenia 4 (50%) was found in the group with the highest risk
of mortality (p=0.05). A negative and moderate association was found between MNA®
and the risk for dysphagia (rho= - 0.59; p=0.03), moderate between MNA® and ICCI
(rho=0.62; p=0.02), and a negative and strong relationship between risk of swallowing
and HGS (rho - 0.67; p= 0.01). Therefore, the present study showed that
institutionalized elderly people, with a high risk of mortality, had multimorbidity,
overweight, dyspenia and risk for dysphagia. And older adults at higher risk for
dysphagia were also at higher risk for malnutrition. The inclusion of the ICCI in a longstay institution can be a strategy for monitoring and establishing multidisciplinary care
strategies.