誤嚥性肺炎のリスクがある高齢者の摂食のための未熟な口腔内予備形成

Premature oral pre-shaping for feeding in elderly population with risk of aspiration pneumonia.

抄録

本研究の目的は、誤嚥性肺炎のリスクが高い高齢者において、食事のために実際に嚥下する前の手と口の行動の異常を明らかにすることであった。誤嚥性肺炎の診断を受けた高齢者（EAP）10名、健常高齢者（HE）15名、若年成人（YA）21名を登録した。自己摂食時と補助摂食時の摂食時間と上唇と下唇の距離が最大になるタイミングをモーションアナライザーを用いて抽出した。その結果，EAPの摂食時間は，自己摂食および補助摂食において，他の群に比べて有意に長かった。また，自力摂食時には，EAP群の口の準備のタイミングが他の群よりも有意に早く，逆に，補助摂食時には，EAP群のタイミングが有意に遅れていた。この結果から、誤嚥性肺炎の経験がある高齢者では、自力・介助ともに、実際に飲み込む前の口の形の準備や手の動きの時間に異常がある可能性が示された。

The aim of this study was to determine the abnormal hand and mouth behavior before actual swallowing for eating in elderly people with high risk of aspiration pneumonia. Ten elderly people with a diagnosis of aspiration pneumonia (EAP), 15 healthy elderly (HE) people, and 21 young adults (YA) were enrolled. The feeding time and the timing of the maximum distance between the upper and lower lips were extracted using a motion analyzer during self-feeding and assisted-feeding. The results showed that feeding time in EAP was significantly longer than that for the other groups in self- and assisted-feeding. In self-feeding, the timing of mouth-preparation in the EAP group was significantly earlier than that in the other groups; conversely, in assisted-feeding, the timing in EAP was significantly delayed. Our results indicate that abnormal preparation of mouth-shape and movement time of hand before actual swallowing in both self- and assisted-feeding may exist in elderly people with previous experience of aspiration pneumonia.