A influência da idade na deglutição orofaríngea de adultos e idosos saudáveis
Data
2024-06-11
Autores
Dall’Oglio, Giovana Piovesan 
Orientadores
Abrahão, Márcio
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivos: Caracterizar o perfil da deglutição da população adulta e idosa saudável, avaliar a autopercepção da deglutição através do questionário EAT-10, avaliar a concordância entre os examinadores quanto aos parâmetros da VED, identificar sinais (parâmetros qualitativos) sugestivos do desenvolvimento da disfagia e a influência da idade na deglutição.
Métodos: Foram recrutados 184 voluntários adultos a partir dos 20 anos de idade. Os voluntários responderam ao questionário EAT-10 e foram submetidos à videoendoscopia da deglutição (VED). Os achados da avaliação instrumental foram descritos conforme faixa etária e relacionados às questões do EAT-10.
Resultados: A idade variou de 20 a 97 anos, sendo 86 homens (46,7%). Não houve correlação do questionário EAT-10 com a idade ou com os achados da VED. O perfil da deglutição do adulto saudável se caracterizou por ausência de escape posterior, disparo do reflexo da deglutição até a valécula, clareamento total do alimento em 2 deglutições para todas as consistências ofertadas em mais de 90% dos casos. Não sequenciamento da deglutição, estase salivar, resíduo, penetração e aspiração (variáveis de interesse) de uma ou mais consistências foram encontrados respectivamente em 3,8%, 3,26%, 13,6%, 4,89% e 0,5% da amostra. Houve associação estatisticamente significativa entre a presença de estase salivar e idade, assim como do resíduo total (R-total: todas as consistências) e idade. A maior proporção de presença de estase salivar e R-total ocorreu na faixa etária ≥80 anos (p=0,039). Nossos resultados não mostraram associação estatisticamente significativa entre penetração e idade. Não houve significância estatística na associação entre as variáveis de interesse na VED (p≤0,05), exceto para a associação penetração e resíduo (p=0,003).
Conclusões: O perfil da deglutição da população adulta e idosa saudável foi determinado. O questionário EAT-10 não se mostrou útil na autopercepção de disfagia. Houve alto valor de concordância entre os examinadores para todos os parâmetros. A presença de resíduo infere alteração da eficiência da deglutição, portanto disfagia, e quando associado à penetração reforça o diagnóstico de disfagia e infere alteração da segurança da deglutição. A idade não influencia a deglutição de adultos e idosos saudáveis de forma linear, porém, a população com idade superior a 80 anos mostrou predomínio dos achados sugestivos de disfagia. Estes dados representam novos valores de referência, que poderão ser utilizados como comparativos em trabalhos futuros.
Objectives: To characterize the swallowing profile of the healthy adult and elderly population, to assess self-perception of swallowing using the EAT-10 questionnaire, to evaluate the agreement between examiners regarding the parameters of the FEESS, to identify signs (qualitative parameters) suggestive of the development of dysphagia and the influence of age on swallowing. Methods: 184 adult volunteers from 20 years of age were recruited. The volunteers answered the EAT-10 questionnaire and underwent swallowing videoendoscopy (FEESS). The instrumental assessment findings were described according to age group and related to the EAT-10 questions. Results: Age ranged from 20 to 97 years old, 86 men (46,7%). There was no correlation between the EAT-10 questionnaire and age or FEESS findings. The swallowing profile of the healthy adult was characterized by the absence of posterior escape, triggering of the swallowing reflex up to the vallecula, total clearing of the food in 2 swallows for all consistencies offered in more than 90% of the cases. Non- sequencing of swallowing, salivary stasis, residue, penetration and aspiration (variables of interest) of one or more consistencies was found respectively in 3.8%, 3.26%, 13.6%, 4.89% and 0.5% of the sample. There was a statistically significant association between the presence of salivary stasis and age, as well as the total residue (R-total : all consistencies) and age. The highest proportion of presence of salivary stasis and R-total occurred in the age group ≥80 years old. Our results did not show a statistically significant association between penetration and age. There was no statistically significant association between the variables of interest in the FEESS (p≤0.05), except for the association between penetration and residue (p=0.003). Conclusions: The swallowing profile of the healthy adult and elderly population was determined. The EAT-10 questionnaire did not prove useful in the self-perception of dysphagia.There was a high level of agreement between the examiners for all parameters.The presence of residue indicates altered swallowing efficiency, therefore dysphagia, and when associated with penetration it reinforces the diagnosis of dysphagia and indicates altered swallowing safety. Age does not influence the swallowing of healthy adults and elderly people in a linear way, but the population aged over 80 showed a predominance of findings suggestiveof dysphagia. These data represent new reference values that can be used as comparisons in future studies.
Objectives: To characterize the swallowing profile of the healthy adult and elderly population, to assess self-perception of swallowing using the EAT-10 questionnaire, to evaluate the agreement between examiners regarding the parameters of the FEESS, to identify signs (qualitative parameters) suggestive of the development of dysphagia and the influence of age on swallowing. Methods: 184 adult volunteers from 20 years of age were recruited. The volunteers answered the EAT-10 questionnaire and underwent swallowing videoendoscopy (FEESS). The instrumental assessment findings were described according to age group and related to the EAT-10 questions. Results: Age ranged from 20 to 97 years old, 86 men (46,7%). There was no correlation between the EAT-10 questionnaire and age or FEESS findings. The swallowing profile of the healthy adult was characterized by the absence of posterior escape, triggering of the swallowing reflex up to the vallecula, total clearing of the food in 2 swallows for all consistencies offered in more than 90% of the cases. Non- sequencing of swallowing, salivary stasis, residue, penetration and aspiration (variables of interest) of one or more consistencies was found respectively in 3.8%, 3.26%, 13.6%, 4.89% and 0.5% of the sample. There was a statistically significant association between the presence of salivary stasis and age, as well as the total residue (R-total : all consistencies) and age. The highest proportion of presence of salivary stasis and R-total occurred in the age group ≥80 years old. Our results did not show a statistically significant association between penetration and age. There was no statistically significant association between the variables of interest in the FEESS (p≤0.05), except for the association between penetration and residue (p=0.003). Conclusions: The swallowing profile of the healthy adult and elderly population was determined. The EAT-10 questionnaire did not prove useful in the self-perception of dysphagia.There was a high level of agreement between the examiners for all parameters.The presence of residue indicates altered swallowing efficiency, therefore dysphagia, and when associated with penetration it reinforces the diagnosis of dysphagia and indicates altered swallowing safety. Age does not influence the swallowing of healthy adults and elderly people in a linear way, but the population aged over 80 showed a predominance of findings suggestiveof dysphagia. These data represent new reference values that can be used as comparisons in future studies.
Descrição
Citação
DALL’OGLIO, Giovana Piovesan. A influência da idade na deglutição orofaríngea de adultos e idosos saudáveis. 2024. 118 f. Tese (Doutorado em Otorrinolaringologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.