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: 8454011
• 负责人: Samantha Eve Shune
• 金额: $ 2.92万
• 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 2014-09-11
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8454011
• 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. PUBLIC HEALTH RELEVANCE: Swallowing problems contribute to the high financial, physical, and psychosocial costs associated with disease, particularly in the elderly. Despite the implication of increased safety associated with feeding assistance for these individuals, the influence and potential risks of absent pre-oral sensory cues on an already taxed system are unclear. By examining the relationship between these pre-oral cues and anticipatory oral posturing during eating and swallowing in healthy elderly individuals, this research is positioned to address the potential for increased risk these recommendations may elicit, enhancing swallowing-related practices and interventions.

描述（由申请人提供）：该项目的总体目标是促进对饮食过程中发生的与年龄相关的生理和功能变化的理解，从而为有吞咽问题的个体设计更有效的治疗方法，特别是在人口老龄化中。在许多老年人中常见的认知、身体和感觉障碍，特别是在存在共病神经系统障碍（例如痴呆）的情况下，通常会导致饮食需求得不到满足，从而导致发病率和过早死亡率增加。其中许多人的功能限制需要在摄入食物和液体方面提供广泛或全面的帮助。然而，尽管与辅助喂养相关的安全性有所提高，但消除该建议所产生的线索（例如，手/手臂的本体感觉）对已经负荷过重的系统的影响和潜在增加的风险尚不清楚。关于这些口前或预期的线索和刺激对“安全饮食和吞咽”过程的贡献的文献有限。为了解决这一临床相关问题，该项目旨在：（1）确定年轻人和老年人在吞咽前阶段存在的涉及手/臂、嘴唇和下巴的协同肌肉模式； (2) 确定非口咽感觉信息和反馈的改变对年轻人和老年人启动和改变这些口腔运动模式的影响。该提案的实验方法利用肌电图和光学运动检测技术来检查典型进食和吞咽过程中发生的预期反应和纠错模式中与年龄相关的变化。这项工作意义重大，因为吞咽预期阶段和吞咽前计划的中断不仅在需要喂养帮助的个体亚群中很常见，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、右半球疾病、中风、和脑外伤。这项研究中获得的知识将有助于区分正常衰老的影响与这些疾病造成的影响，这对于设计适当的评估和干预技术非常重要。确定吞咽预期阶段的感觉反馈中断是否会影响后期吞咽的模式和时间，可能会导致开发有效喂养实践和吞咽策略的新方法，旨在预防老年人和老年人的吞咽困难和上呼吸道损害。跨临床人群。 公共卫生相关性：吞咽问题会导致与疾病相关的高昂经济、身体和社会心理成本，尤其是老年人。尽管与这些人的喂养援助相关的安全性有所提高，但缺乏口前感官线索对已经不堪重负的系统的影响和潜在风险尚不清楚。通过检查健康老年人在进食和吞咽过程中这些口前线索与预期口腔姿势之间的关系，本研究旨在解决这些建议可能引起的风险增加的可能性，从而加强与吞咽相关的实践和干预措施。