Abstract
To delay impacts of aging, optimal nutritional status is essential. Several factors can reduce food intake, such as isolation, income, and cognitive/physical decline. Additionally, chewing and swallowing difficulties, or dysphagia, often disrupt the ability to consume life-long favorite dishes. Food and liquids could require modification of texture or consistency to ensure a comfortable or safe swallow. The food industry, foodservices facilities, and caregivers need quality control benchmarks to provide adequate nourishment and meet these new feeding challenges. The International Dysphagia Diet Standardisation Initiative (IDDSI) is proposing the IDDSI framework and testing methods to describe food used in nutritional care plans to circumvent dysphagia and improve communication among caregivers. This systematic review assesses the validity and reliability of the IDDSI testing methods using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN). Two publications presented content validity whereas 19 publications looked at construct validity or reliability for the IDDSI testing methods. One study was conducted in older adults presenting dysphagia. This review concludes that there is insufficient evidence to recommend the IDDSI testing methods. Further research, conducted with robust methodological design and reporting, is needed to develop and assess nutritious adapted food for frail older populations.
Highlights
To avoid or delay health decline associated to aging, appropriate nutritional intake is frequently an essential part of the solution
Food intake could be affected by poor oral health, difficulty in chewing or swallowing—dysphagia—which has been associated to undernutrition [4,5,6]
No studies have shown that the proposed terminology and levels improve the treatment of dysphagia, whether on acceptability, quality of life, nutritional status, hydration, or aspiration pneumonia
Summary
To avoid or delay health decline associated to aging, appropriate nutritional intake is frequently an essential part of the solution. Food intake could be affected by poor oral health, difficulty in chewing or swallowing—dysphagia—which has been associated to undernutrition [4,5,6]. In the complex geriatric context, Okazaki and colleagues (2019) recently. In the complex geriatric context, Okazaki and colleagues (2019) recently presented the concept of presented the concept of “vicious circle of aspiration pneumonia” where sarcopenia, undernutrition,. “vicious circle of aspiration pneumonia” where sarcopenia, undernutrition, and inflammation are at and inflammation are at the core of recurrent aspiration pneumonia [7]. Sarcopenia is recognized as the core of recurrent aspiration pneumonia [7]. Sarcopenic dysphagia and presbyphagia, defined as age-related changes in the swallowing presbyphagia, defined as age-related changes in the swallowing mechanism, are investigated with mechanism, are investigated with more interest recently [9]. Deterioration in immune system functions, known as immunosenescence, functions, known as immunosenescence, is well documented in the older adult population and is well documented in the older adult population and is acerbated by poor nutritional status [10,11]
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