Yoko Hokotachi1,2, Ayako Tsunou1,3, Hiroyo Miyata1,4 and Teruyoshi Amagai1,5*
1Administration Food Sciences and Nutrition Major, Graduate School of Human Environmental Sciences, Mukogawa Women’s University, Hyogo, Japan
2Department of Clinical Nutrition, Takarazuka-Daiichi Hospital, Hyogo, Japan
3Department of Clinical Nutrition, Kitauwa Hospital, Ehime, Japan
4Department of Clinical Nutrition, Kindai University Hospital, Osaka, Japan
5Department of Clinical Engineering, Jikei University of Health Care Sciences, Osaka, Japan
Aims: To test our hypothesis that swallowing capacity evaluated at admission is associated with poorly improving Activities of Daily Living (ADL) in older adult inpatients and that they must be target of earlier nutritional intervention including nutritional counseling conducted by registered dietitians. Methods: Recruited subjects were consecutive all inpatients aged ≥ 65 years old admitted to a single hospital met without exclusion criteria. After dividing included subjects by with the International Dysphagia Diet Standardization Initiative Functional Diet Scale (IDDSI-FDS) score <7 (low) vs. ≥ 7 (high) at admission, all collected data was compared to draw which patients must be target of intensive nutritional intervention to achieve relevant outcome. Results: 95 patients out of 167 were included with low- vs. high-IDDSI score (n=24 vs. 71, respectively). FOIS and IDDSI score in low-group showed significantly smaller ADL change measured by differences between Barthel Index (BI) between admission and discharge compared with in high-group (0 vs. 15, respectively: p=0.004), instead nutritional management added with parenteral nutrition. The logistic regression analysis showed that odds ratio of IDDSI-FDS for BI improvement was 2.061 (95% CI: 1.124-3.777: p=0.019). Conclusion: The IDDSI score seems have an association of swallowing dysfunction followed by smaller BI improvement in older adult patient's ≥ 65 years old who must be target of intensive nutritional intervention to prevent poor outcome.
Functional Oral Intake Scale (FOIS); The International Dysphagia Diet Standardization Initiative Functional Diet Scale (IDDSI-DS); Older adult; Swallowing difficulty
Hokotachi Y, Tsunou A, Miyata H, Amagai T. A Novel Framework for Texture-Modified Diets is Associated with ADL Improvement in Older Adult Patients. Clin Surg. 2021; 6: 3343..