Abstract

Oropharyngeal dysphagia is widespread in geriatric patients and is nearly always multicausal. It is often insufficiently recognized and leads to severe complications. The available and established screening tools all focus primarily on patients with neurological diseases, usually following a stroke. The working group on dysphagia of the German Society of Geriatrics (DGG), which is comprised of physicians, speech and language therapists and dysphagia therapists, performed aliterature review on dysphagia screening tools. Based on the results of the literature search and own experience, anew screening instrument suitable for geriatric patients was developed and agreed by the consensus group. The new screening instrument for the detection of oropharyngeal dysphagia in geriatric patients consists of three parts: 1)consciousness and posture control while sitting, 2)ability to swallow saliva and to cough as well as tongue motility and 3)the water swallowing test. The screening can be applied by trained medical personnel and can easily be integrated into everyday practice. The new screening tool is especially aimed at geriatric patients. It has advantages compared to previously recommended screening tests. Initial experiences with the instrument show good practicability and acceptance in geriatric teams. Further studies have to test the validity of the instrument.

Highlights

  • Oropharyngeal dysphagia is widespread in geriatric patients and is nearly always multicausal

  • The working group on dysphagia of the German Society of Geriatrics (DGG), which is comprised of physicians, speech and language therapists and dysphagia therapists, performed a literature review on dysphagia screening tools

  • The new screening instrument for the detection of oropharyngeal dysphagia in geriatric patients consists of three parts: 1) consciousness and posture control while sitting, 2) ability to swallow saliva and to cough as well as tongue motility and 3) the water swallowing test

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Summary

E: Aspirationsrisiko

Durch die Arbeitsgruppe erfolgte 2014 eine Umfrage an deutschen geriatrischen Kliniken zur Praxis der Dysphagiediagnostik. Die Limitationen der vorhandenen Tests lassen sich beispielhaft am Daniels-Test [6] illustrieren, der aufgrund seiner guten Spezifität, Sensitivität und Sicherheit mit schrittweise zunehmenden Volumina des Wasserschlucks in geriatrischen Kliniken in Deutschland verbreitet ist. Basierend auf den Erfahrungen der Mitglieder der AG Dysphagie, der vorliegenden Evidenz sowie der genannten Umfrage wurden Elemente für ein neues Instrument zum Dysphagiescreening zusammengestellt und konsentiert In der Arbeitsgruppe „Dysphagie“ der Deutschen Gesellschaft für Geriatrie (DGG), in der Ärzte, Logopäden und Schlucktherapeuten zusammengeschlossenen sind, erfolgte eine selektive Literaturrecherche zum Dysphagiescreening. Basierend auf Ergebnissen der Literaturrecherche und eigenen Erfahrungen wurde durch eine Konsensgruppe ein neues Screeninginstrument für geriatrische Patienten entwickelt und konsentiert. Das neu entwickelte Screeninginstrument ist speziell für die Anwendung bei geriatrischen Patienten vorgesehen. Development of a new screening instrument for screening of dysphagia in geriatric patients: the dysphagia screening tool geriatrics

Orale Inspektion
Wasserschlucktest
Literatur
Full Text
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