Effects of chronic use of thickened liquids in a rat model of aging

长期使用增稠液体对衰老大鼠模型的影响

• 批准号: 10728328
• 负责人: Linda M Rowe
• 金额: $ 4.72万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-07 至 2024-09-06
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10728328
• 关键词: Address; Affect; Age; Aging; Animal Model; Aspiration Pneumonia; Behavioral Assay; Benefits and Risks; Biological; Biological Assay; Biology; Blood specimen; Bolus Infusion; Cephalic; Chronic; Clinical; Clinical Research; Clinical Treatment; Contracts; Deglutition; Deglutition Disorders; Dehydration; Disease; Dose; Elderly; Equilibrium; Event; Exposure to; Fast-Twitch Muscle Fibers; Food; Foundations; Frequencies; Future; Goals; Guidelines; Health; Health care facility; Hematocrit procedure; Hydration status; Individual; Institute of Medicine (U.S.); Intake; Intervention; Invaded; Knowledge; Liquid substance; Long-Term Effects; Malnutrition; Measurement; Measures; Medical; Methods; Modeling; Monitor; Movement; Muscle; Muscle Contraction; Myosin Heavy Chains; Nonmuscle Myosin Type IIB; Oral; Oropharyngeal Dysphagia; Outcome; Outcome Measure; Patient risk; Patients; Persons; Physiology; Population; Property; Protein Isoforms; Quality of life; Rattus; Recommendation; Research; Risk; Solid; Speed; Stimulus; System; Testing; Texture; Thinness; Time; Tissues; Tongue; Translations; Urinary tract infection; Viscosity; Work; age effect; age related; aging population; aspirate; clinical decision-making; clinically relevant; compliance behavior; genioglossus muscle; improved; insight; kinematics; medical complication; mortality; nutrition; prevent; respiratory; response; young adult

Abstract Swallowing disorders are highly prevalent in elderly people, including those with age-related diseases. Thickened liquids are frequently used in the treatment of swallowing disorders and have been shown to immediately reduce the chance of airway invasion. However, thickened liquids have been associated with deleterious health effects such as dehydration, urinary tract infection, and reduced quality of life. Despite their common clinical use, the long-term efficacy of thickened liquids, and their effect on swallowing kinematics, systemic hydration, and underlying biology, is not well understood. Given the rapidly increasing population of persons over 65, estimated to reach 2.1 billion by 2051, it is critical to understand the efficacy of dysphagia interventions. The overarching goal of this proposal is to contribute foundational knowledge of biological mechanisms underlying functional swallowing changes in response to a frequently used, but understudied, intervention for dysphagia management in the aging population. The proposed study will use an aging rat model to interrogate how use of thickened liquids affects swallowing kinematics, systemic hydration, and underlying biology over time. We have 3 specific aims, each with a unique hypothesis. Aim 1 will test the hypothesis that chronic use of thickened liquid textures reduces bolus speed, reduces coordination of swallowing muscles, and disrupts normal respiratory-swallow event sequencing. Aim 2 will test the hypothesis that thickened liquids result in reduced volume of fluid intake and systemic dehydration, which will be exacerbated by viscosity and age. Aim 3 will test the hypothesis that thickened liquids, in the absence of thin liquid, will slow swallowing movements, dynamically altering muscle contractile properties to include reduced tongue forces and increased contraction times in an age-dependent manner. In concert, the proportion of fast- contracting type IIb myosin heavy chain (MyHC) isoforms in the tongue will be reduced, causing an increased proportion of slower-contracting isoforms, such as type IIa and type I. This research is highly significant in that it will be the first in an aging animal model to examine the effects of thickened liquids on systemic hydration along with underlying muscle biology, kinematics, and physiology, and the relationship to clinically relevant outcome measures of swallow function. Knowledge gained from this work will lead to hypotheses for testing in clinical studies that are crucial for clinical decisions that must balance patient risk of aspiration and subsequent medical complications, against the impact of potential deleterious effects of thickened liquids on patient overall medical status and quality of life.

抽象的 吞咽障碍在老年人中非常普遍，包括那些患有与年龄相关的疾病的人。 增稠液体经常用于治疗吞咽障碍，并已被证明可以 立即减少气道侵入的机会。然而，稠化的液体与 对健康造成有害影响，例如脱水、尿路感染和生活质量下降。尽管他们的 临床常见用途、增稠液体的长期功效及其对吞咽运动学的影响， 全身水合作用和基础生物学尚不清楚。鉴于人口的迅速增长 预计到 2051 年，65 岁以上的人口将达到 21 亿，了解吞咽困难的疗效至关重要 干预措施。该提案的总体目标是贡献生物学的基础知识 吞咽功能变化的潜在机制是针对经常使用但尚未充分研究的 老年人吞咽困难管理的干预措施。拟议的研究将使用衰老大鼠 模型来探究增稠液体的使用如何影响吞咽运动、全身水合和 随着时间的推移，基础生物学。我们有 3 个具体目标，每个目标都有一个独特的假设。目标 1 将测试 假设长期使用增稠的液体质地会降低推注速度，降低药物的协调性 吞咽肌肉，并扰乱正常的呼吸-吞咽事件顺序。目标 2 将检验假设 稠化的液体会导致液体摄入量减少和全身脱水，这将 粘度和老化加剧。目标 3 将检验以下假设：在没有稀薄液体的情况下，液体会变稠 液体，会减慢吞咽运动，动态改变肌肉收缩特性，包括减少 舌头的力量和收缩时间的增加与年龄有关。一致地，快速的比例 舌头中收缩的 IIb 型肌球蛋白重链 (MyHC) 同工型将减少，导致 较慢收缩异构体的比例，例如 IIa 型和 I 型。这项研究非常重要，因为 这将是第一个在衰老动物模型中检查增稠液体对全身水合作用的影响的项目 以及潜在的肌肉生物学、运动学和生理学，以及与临床相关的关系 吞咽功能的结果测量。从这项工作中获得的知识将产生用于测试的假设 对必须平衡患者误吸风险和随后的临床决策至关重要的临床研究 医疗并发症，针对增稠液体对患者整体潜在有害影响的影响 医疗状况和生活质量。