Effects of Aging on Anticipatory Functional Synergies Activated in Deglutition

衰老对吞咽过程中激活的预期功能协同作用的影响

• 批准号: 8568592
• 负责人: Samantha Eve Shune
• 金额: $ 2.3万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-12 至 2014-06-11
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8568592
• 关键词: Address; Affect; Age; Aging; Clinical; Cognitive; Complex; Coupling; Cues; Deglutition; Deglutition Disorders; Dementia; Detection; Development; Disease; Eating; Elderly; Electromyography; Ensure; Esthesia; Excision; Feedback; Food; Freedom; Functional disorder; Goals; Hand; Healthcare; Hunger; Impairment; Individual; Injury; Intervention; Jaw; Knowledge; Lead; Lip structure; Liquid substance; Literature; Modification; Morbidity - disease rate; Motion; Movement; Muscle; Nervous system structure; Neurologic; Neurophysiology - biologic function; Normal Range; Nutritional; Optics; Oral; Oral Stage; Oral cavity; Oropharyngeal; Participant; Pattern; Peripheral; Physiological; Play; Population; Positioning Attribute; Posture; Premature Mortality; Prevalence; Process; Proprioception; Recommendation; Recovery; Relative (related person); Research; Risk; Role; Safety; Secondary to; Sensory; Staging; Stimulus; Stroke; Structure; System; Taxes; Techniques; Time; Traumatic Brain Injury; Vision; Work; age effect; age related; aging population; arm; clinically relevant; cost; design; experience; feeding; improved; mortality; motor control; muscle form; muscle strength; nervous system disorder; normal aging; novel strategies; oral motor; oral sensory; prevent; psychosocial; relating to nervous system; response; sensory feedback; somatosensory; young adult

DESCRIPTION (provided by applicant): The overall goal of this project is to contribute to the understanding of the age-related physiological and functional changes that occur across the eating process, leading to the design of more efficacious treatments for individuals with swallowing problems, particularly in the aging population. The combination of cognitive, physical, and sensory impairments commonly seen in many elderly individuals, especially in the presence of co-morbid neurologic impairment (e.g., dementia), often results in eating needs going unmet, leading to increased morbidity and premature mortality. The functional limitations of many of these individuals necessitate extensive or total assistance with consuming foods and liquids. However, despite the implication of increased safety associated with assisted feeding, the influence and potential increased risk of the elimination of cues resulting from this recommendation (e.g., proprioception from the hand/arm) on an already taxed system are unclear. Limited literature is available regarding the contribution of these pre-oral, or anticipatory, cues and stimuli to the process of "safe eating and swallowing". To address this clinically-relevant problem, this project seeks to: (1) identify the synergistic muscle patterns involving the hand/arm, lips, and jaw that are present during the pre-oral stage of deglutition in younger and older adults; and (2) to determine the influence of modifications in non-oropharyngeal sensory information and feedback on initiating and altering these oral motor patterns in younger and older adults. The experimental approach of this proposal capitalizes on the opportunity to utilize electromyography and optical motion detection techniques to examine the age-related changes in anticipatory responses and error correction patterns that occur during typical eating and swallowing. This work is significant as disruptions in the anticipatory stage of swallowing and pre-swallowing planning are common not only in the subpopulation of individuals requiring feeding assistance, but are additionally prominent in individuals with numerous neurological diseases, including dementia, right hemisphere disorder, stroke, and traumatic brain injury. The knowledge gained in this study will help disassociate the effects of normal aging from those due to these diseases, important in the design of appropriate assessment and intervention techniques. Determining whether or not disruptions in sensory feedback during the anticipatory stage of swallowing affect the pattern and timing of later swallowing may then lead to the development of new approaches to effective feeding practices and swallowing strategies aimed at preventing dysphagia and upper airway compromise in the elderly and across clinical populations.

描述（由申请人提供）：该项目的总体目标是有助于理解整个饮食过程中与年龄相关的生理和功能变化，从而为患有吞咽问题的人（尤其是在衰老人群中）设计了更有效的治疗方法。在许多老年人中通常看到的认知，身体和感觉障碍的结合，尤其是在存在合并神经系统障碍（例如痴呆症）的情况下，通常会导致饮食需求未满足，从而增加了发病率和早期死亡率。许多这些人的功能局限性需要在食用食物和液体方面进行广泛或全面的帮助。但是，尽管与辅助喂养相关的安全性增加含义，但尚不清楚该建议（例如，手/臂的本体感受）在已经征税的系统上消除提示的影响和潜在的风险尚不清楚。关于这些口腔前或预期的线索和刺激对“安全饮食和吞咽”过程的贡献，可用的文献有限。为了解决这个与临床相关的问题，该项目试图：（1）确定在年轻和老年人中脱毛前的脱毛前阶段中存在的涉及手/手臂，嘴唇和下颌的协同肌肉模式； （2）确定在非咽喉感觉信息中修饰的影响，以及有关在年轻和老年人中启动和改变这些口服运动模式的反馈。该提案的实验方法利用了利用肌电图和光学运动检测技术的机会来检查典型饮食和吞咽过程中发生的预期响应和误差校正模式的与年龄相关的变化。这项工作非常重要，因为在吞咽的预期阶段的破坏和磨损前的计划不仅在需要喂养辅助的个体的亚群中很常见，而且在患有多种神经系统疾病的个体中也很突出，包括痴呆症，右半球疾病，中风，中风和创伤性大脑损伤。在这项研究中获得的知识将有助于使正常衰老的影响与这些疾病引起的影响分解，这对于设计适当的评估和干预技术很重要。在吞咽的预期阶段确定感觉反馈的破坏是否会影响后来的吞咽的模式和时间，可能会导致开发新方法，从而开发出有效的喂养实践和吞咽策略，旨在防止吞咽困难和跨临床种群在老年人和整个临床种群中损害上越野疾病。