通所介護を利用する高齢者のサルコペニアの摂食嚥下障害に関する要因—食事摂取に関連する生活背景に焦点を当てて

Factors Associated with Sarcopenic Dysphagia in Older Adults Who Use Day-Care Services: Focus on Lifestyle Backgrounds Related to Food Intake

抄録

　本研究の目的は，通所介護を利用し，サルコペニアを有する要支援・要介護高齢者におけるサルコペニアの摂食嚥下障害（sarcopenic dysphagia：SD）の関連要因を明らかにし，予防・改善に向けた支援の示唆を得ることである．

　通所介護を利用する，地域在住の要支援・要介護高齢者78人を対象者とした．身体機能や栄養状態，認知機能，口腔・嚥下機能，食事摂取に関連する生活背景についてデータを収集し，χ²検定，Mann-WhitneyのU検定，ロジスティック回帰分析を実施した．

　対象者78人のうち，サルコペニアの者は49人（62.8％），SDの者は13人（16.7％）であった．サルコペニアの者49人におけるSDの関連要因として，年齢（OR：1.489, 95％CI：1.053-1.597），舌圧（OR：0.92，95％CI：0.557-0.973），食品摂取多様性得点（OR：0.85, 95％CI：0.264-0.959）が抽出された．

　サルコペニアを有する要支援・要介護高齢者におけるSD予防には，食品摂取多様性や舌圧の維持・向上に向けた生活指導や指導内容を継続できるためのアプローチが必要であることが示唆された．

　The purpose of this study was to clarify the factors associated with sarcopenic dysphagia (SD) in community-dwelling older adults who utilize day care services and have sarcopenia, and to gain insights for its prevention and improvement.

　Seventy‐eight such older adults were enrolled. Data on physical function, nutritional status, cognitive function, oral and swallowing functions, and dietary habits related to malnutrition were collected, and chi-square tests, Mann-Whitney U tests, and logistic regression analyses were performed.

　Among the 78 participants, 49 (62.8%) had sarcopenia and 13 (16.7%) had SD. In the subgroup of 49 participants with sarcopenia, age (OR: 1.489, 95% CI: 1.053-1.597), tongue pressure (OR: 0.92, 95% CI: 0.557-0.973), and dietary variety score (OR: 0.85, 95% CI: 0.264-0.959) were identified as factors associated with SD.

　These findings suggest that for older adults with sarcopenia requiring support or care, approaches aimed at maintaining or improving dietary variety and tongue pressure through continuous lifestyle guidance are necessary for the prevention of SD.