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Когнитивные расстройства и дисфагия в пожилом возрасте
Когнитивные расстройства и дисфагия в пожилом возрасте
Остапенко В.С., Мхитарян Э.А. Когнитивные расстройства и дисфагия в пожилом возрасте. Consilium Medicum. 2024;26(2):131–134. DOI: 10.26442/20751753.2024.2.202674
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Люди пожилого и старческого возраста зачастую страдают когнитивными расстройствами. Одной из значимых проблем, развивающихся по мере нарастания выраженности когнитивных нарушений, является дисфагия. В статье рассмотрены различные причины дисфагии и способы ее коррекции. Учитывая высокую распространенность дисфагии у пациентов с когнитивными нарушениями, при подборе терапии когнитивных расстройств зачастую возникают сложности. В связи с тем, что у пациентов с дисфагией возникают трудности при приеме твердых лекарственных форм (ЛФ) – таблеток и капсул, обсуждаются альтернативные ЛФ. В частности, приводятся исследования положительного влияния на когнитивный статус Церетона и применения его разных ЛФ, которые позволяют обеспечить оптимальную терапию в различных ситуациях. Новая ЛФ Церетона – раствор для приема внутрь – удобна для применения у пациентов с дисфагией.
Ключевые слова: орофарингеальная дисфагия, когнитивные расстройства, деменция, гериатрический синдром, холина альфосцерат, Церетон
Keywords: oropharyngeal dysphagia, cognitive disorders, dementia, geriatric syndrome, choline alfoscerate, Cereton
Ключевые слова: орофарингеальная дисфагия, когнитивные расстройства, деменция, гериатрический синдром, холина альфосцерат, Церетон
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Keywords: oropharyngeal dysphagia, cognitive disorders, dementia, geriatric syndrome, choline alfoscerate, Cereton
Полный текст
Список литературы
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18. Kishi T, Matsunaga S, Oya K, et al. Protection against Brain Atrophy by Anti-dementia Medication in Mild Cognitive Impairment and Alzheimer’s Disease: Meta-Analysis of Longitudinal Randomized Placebo-Controlled Trials. Int J Neuropsychopharmacol. 2015;18(12):pyv070. DOI:10.1093/ijnp/pyv070
19. Гаврилова С.И., Колыхалов И.В., Пономарева Е.В., и др. Клиническая эффективность и безопасность применения холина альфосцерата в лечении додементных когнитивных нарушений в позднем возрасте. Журнал неврологии и психиатрии им. С.С. Корсакова. 2018;118(5):45-53 [Gavrilova SI, Kolykhalov IV, Ponomareva EV, et al. Clinical efficacy and safety of choline alfoscerate in the treatment of late-onset cognitive impairment. SS Korsakov Journal of Neurology and Psychiatry. 2018;118(5):45-53 (in Russian)]. DOI:10.17116/jnevro20181185145
20. Пономарева Е.В. Эффективность холина альфосцерата в лечении пациентов с мягким когнитивным снижением амнестического типа: сравнительное проспективное исследование. Психиатрия. 2023;21(1):62-72 [Ponomareva EV. The Effectiveness of Choline Alfoscerate in the Treatment of Patients with Amnestic Mild Cognitive Impairment: A Comparative Prospective Study. Psikhiatriya. 2023;21(1):62-72 (in Russian)]. DOI:10.30629/2618-6667-2023-21-1-62-72
21. Amenta F, Carotenuto A, Fasanaro AM, et al. The ASCOMALVA (Association between the Cholinesterase Inhibitor Donepezil and the Cholinergic Precursor Choline Alphoscerate in Alzheimer’s Disease) Trial: interim results after two years of treatment. J Alzheimers Dis. 2014;42(Suppl. 3):S281-8. DOI:10.3233/JAD-140150
22. Traini E, Carotenuto A, Fasanaro AM, Amenta F. Volume Analysis of Brain Cognitive Areas in Alzheimer’s Disease: Interim 3-Year Results from the ASCOMALVA Trial. J Alzheimers Dis. 2020;76(1):317-29. DOI:10.3233/JAD-190623
23. Kang M, Lee DB, Kwon S, et al. Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data. J Clin Med. 2022;11(16):4661. DOI:10.3390/jcm11164661
2. Tkacheva ON, Runikhina NK, Ostapenko VS, et al. Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow. Clin Interv Aging. 2018;13:251-9. DOI:10.2147/CIA.S153389
3. Bogolepova AN, Vasenina EE, Gomzyakova NA, et al. Clinical Guidelines for Cognitive Disorders in Elderly and Older Patients. SS Korsakov Journal of Neurology and Psychiatry. 2021;121(10‑3):6‑137 (in Russian). DOI:10.17116/jnevro20211211036
4. Khenderson DzhM. Patofiziologiia organov pishchevareniia. Moscow: Binom; Saint Petersburg: Nevskii dialekt, 2019 (in Russian).
5. Baijens LW, Clavé P, Cras P, et al. European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016;11:1403-28. DOI:10.2147/CIA.S107750
6. Maniaci A, Lechien JR, La Mantia I, et al. Cognitive Impairment and Mild to Moderate Dysphagia in Elderly Patients: A Retrospective Controlled Study. Ear Nose Throat J. 2022;1455613211054631. DOI:10.1177/01455613211054631
7. Rajati F, Ahmadi N, Naghibzadeh ZA, Kazeminia M. The global prevalence of oropharyngeal dysphagia in different populations: a systematic review and meta-analysis. J Transl Med. 2022;20(1):175. DOI:10.1186/s12967-022-03380-0
8. Affoo RH, Foley N, Rosenbek J, et al. Swallowing dysfunction and autonomic nervous system dysfunction in Alzheimer’s disease: a scoping review of the evidence. J Am Geriatr Soc. 2013;61(12):2203-13. DOI:10.1111/jgs.12553
9. Mao L, Wang J, Li Y, et al. Risk factors for dysphagia in patients with acute and chronic ischemic stroke: A retrospective cohort study. Heliyon. 2024;10(2):e24582. DOI:10.1016/j.heliyon.2024.e24582
10. Alagiakrishnan K, Bhanji RA, Kurian M. Evaluation and management of oropharyngeal dysphagia in different types of dementia: a systematic review. Arch Gerontol Geriatr. 2013;56(1):1-9. DOI:10.1016/j.archger.2012.04.011
11. Michel A, Verin E, Hansen K, et al. Buccofacial Apraxia, Oropharyngeal Dysphagia, and Dementia Severity in Community-Dwelling Elderly Patients. J Geriatr Psychiatry Neurol. 2021;34(2):150-5. DOI:10.1177/0891988720915519
12. Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26(9):1256-65. DOI:10.1111/nmo.12382
13. Wolf U, Eckert S, Walter G, et al. Prevalence of oropharyngeal dysphagia in geriatric patients and real-life associations with diseases and drugs. Sci Rep. 2021;11(1):21955. DOI:10.1038/s41598-021-99858-w
14. Koberskaya NN. Dysphagia in Alzheimer’s disease. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(5):83-9 (in Russian). DOI:10.14412/2074-2711-2022-5-83-89
15. Strachan I, Greener M. Medication-related swallowing difficulties may be more common than we realise. Pharm Pract. 2005;15(10):411-4.
16. Schiele JT, Quinzler R, Klimm HD, et al. Difficulties swallowing solid oral dosage forms in a general practice population: prevalence, causes, and relationship to dosage forms. Eur J Clin Pharmacol. 2013;69(4):937-48. DOI:10.1007/s00228-012-1417-0
17. Logrippo S, Ricci G, Sestili M, et al. Oral drug therapy in elderly with dysphagia: between a rock and a hard place! Clin Interv Aging. 2017;12:241-51. DOI:10.2147/CIA.S121905
18. Kishi T, Matsunaga S, Oya K, et al. Protection against Brain Atrophy by Anti-dementia Medication in Mild Cognitive Impairment and Alzheimer’s Disease: Meta-Analysis of Longitudinal Randomized Placebo-Controlled Trials. Int J Neuropsychopharmacol. 2015;18(12):pyv070. DOI:10.1093/ijnp/pyv070
19. Gavrilova SI, Kolykhalov IV, Ponomareva EV, et al. Clinical efficacy and safety of choline alfoscerate in the treatment of late-onset cognitive impairment. SS Korsakov Journal of Neurology and Psychiatry. 2018;118(5):45-53 (in Russian). DOI:10.17116/jnevro20181185145
20. Ponomareva EV. The Effectiveness of Choline Alfoscerate in the Treatment of Patients with Amnestic Mild Cognitive Impairment: A Comparative Prospective Study. Psikhiatriya. 2023;21(1):62-72 (in Russian). DOI:10.30629/2618-6667-2023-21-1-62-72
21. Amenta F, Carotenuto A, Fasanaro AM, et al. The ASCOMALVA (Association between the Cholinesterase Inhibitor Donepezil and the Cholinergic Precursor Choline Alphoscerate in Alzheimer’s Disease) Trial: interim results after two years of treatment. J Alzheimers Dis. 2014;42(Suppl. 3):S281-8. DOI:10.3233/JAD-140150
22. Traini E, Carotenuto A, Fasanaro AM, Amenta F. Volume Analysis of Brain Cognitive Areas in Alzheimer’s Disease: Interim 3-Year Results from the ASCOMALVA Trial. J Alzheimers Dis. 2020;76(1):317-29. DOI:10.3233/JAD-190623
23. Kang M, Lee DB, Kwon S, et al. Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data. J Clin Med. 2022;11(16):4661. DOI:10.3390/jcm11164661
2. Tkacheva ON, Runikhina NK, Ostapenko VS, et al. Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow. Clin Interv Aging. 2018;13:251-9. DOI:10.2147/CIA.S153389
3. Боголепова А.Н., Васенина Е.Е., Гомзякова Н.А., и др. Клинические рекомендации «Когнитивные расстройства у пациентов пожилого и старческого возраста». Журнал неврологии и психиатрии им. С.С. Корсакова. 2021;121(10-3):6-137 [Bogolepova AN, Vasenina EE, Gomzyakova NA, et al. Clinical Guidelines for Cognitive Disorders in Elderly and Older Patients. SS Korsakov Journal of Neurology and Psychiatry. 2021;121(10‑3):6‑137 (in Russian)]. DOI:10.17116/jnevro20211211036
4. Хендерсон Дж.М. Патофизиология органов пищеварения. М.: Бином; СПб.: Невский диалект, 2019 [Khenderson DzhM. Patofiziologiia organov pishchevareniia. Moscow: Binom; Saint Petersburg: Nevskii dialekt, 2019 (in Russian)].
5. Baijens LW, Clavé P, Cras P, et al. European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016;11:1403-28. DOI:10.2147/CIA.S107750
6. Maniaci A, Lechien JR, La Mantia I, et al. Cognitive Impairment and Mild to Moderate Dysphagia in Elderly Patients: A Retrospective Controlled Study. Ear Nose Throat J. 2022;1455613211054631. DOI:10.1177/01455613211054631
7. Rajati F, Ahmadi N, Naghibzadeh ZA, Kazeminia M. The global prevalence of oropharyngeal dysphagia in different populations: a systematic review and meta-analysis. J Transl Med. 2022;20(1):175. DOI:10.1186/s12967-022-03380-0
8. Affoo RH, Foley N, Rosenbek J, et al. Swallowing dysfunction and autonomic nervous system dysfunction in Alzheimer’s disease: a scoping review of the evidence. J Am Geriatr Soc. 2013;61(12):2203-13. DOI:10.1111/jgs.12553
9. Mao L, Wang J, Li Y, et al. Risk factors for dysphagia in patients with acute and chronic ischemic stroke: A retrospective cohort study. Heliyon. 2024;10(2):e24582. DOI:10.1016/j.heliyon.2024.e24582
10. Alagiakrishnan K, Bhanji RA, Kurian M. Evaluation and management of oropharyngeal dysphagia in different types of dementia: a systematic review. Arch Gerontol Geriatr. 2013;56(1):1-9. DOI:10.1016/j.archger.2012.04.011
11. Michel A, Verin E, Hansen K, et al. Buccofacial Apraxia, Oropharyngeal Dysphagia, and Dementia Severity in Community-Dwelling Elderly Patients. J Geriatr Psychiatry Neurol. 2021;34(2):150-5. DOI:10.1177/0891988720915519
12. Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26(9):1256-65. DOI:10.1111/nmo.12382
13. Wolf U, Eckert S, Walter G, et al. Prevalence of oropharyngeal dysphagia in geriatric patients and real-life associations with diseases and drugs. Sci Rep. 2021;11(1):21955. DOI:10.1038/s41598-021-99858-w
14. Коберская НН. Дисфагия при болезни Альцгеймера. Неврология, нейропсихиатрия, психосоматика. 2022;14(5):83-9 [Koberskaya NN. Dysphagia in Alzheimer’s disease. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(5):83-9 (in Russian)]. DOI:10.14412/2074-2711-2022-5-83-89
15. Strachan I, Greener M. Medication-related swallowing difficulties may be more common than we realise. Pharm Pract. 2005;15(10):411-4.
16. Schiele JT, Quinzler R, Klimm HD, et al. Difficulties swallowing solid oral dosage forms in a general practice population: prevalence, causes, and relationship to dosage forms. Eur J Clin Pharmacol. 2013;69(4):937-48. DOI:10.1007/s00228-012-1417-0
17. Logrippo S, Ricci G, Sestili M, et al. Oral drug therapy in elderly with dysphagia: between a rock and a hard place! Clin Interv Aging. 2017;12:241-51. DOI:10.2147/CIA.S121905
18. Kishi T, Matsunaga S, Oya K, et al. Protection against Brain Atrophy by Anti-dementia Medication in Mild Cognitive Impairment and Alzheimer’s Disease: Meta-Analysis of Longitudinal Randomized Placebo-Controlled Trials. Int J Neuropsychopharmacol. 2015;18(12):pyv070. DOI:10.1093/ijnp/pyv070
19. Гаврилова С.И., Колыхалов И.В., Пономарева Е.В., и др. Клиническая эффективность и безопасность применения холина альфосцерата в лечении додементных когнитивных нарушений в позднем возрасте. Журнал неврологии и психиатрии им. С.С. Корсакова. 2018;118(5):45-53 [Gavrilova SI, Kolykhalov IV, Ponomareva EV, et al. Clinical efficacy and safety of choline alfoscerate in the treatment of late-onset cognitive impairment. SS Korsakov Journal of Neurology and Psychiatry. 2018;118(5):45-53 (in Russian)]. DOI:10.17116/jnevro20181185145
20. Пономарева Е.В. Эффективность холина альфосцерата в лечении пациентов с мягким когнитивным снижением амнестического типа: сравнительное проспективное исследование. Психиатрия. 2023;21(1):62-72 [Ponomareva EV. The Effectiveness of Choline Alfoscerate in the Treatment of Patients with Amnestic Mild Cognitive Impairment: A Comparative Prospective Study. Psikhiatriya. 2023;21(1):62-72 (in Russian)]. DOI:10.30629/2618-6667-2023-21-1-62-72
21. Amenta F, Carotenuto A, Fasanaro AM, et al. The ASCOMALVA (Association between the Cholinesterase Inhibitor Donepezil and the Cholinergic Precursor Choline Alphoscerate in Alzheimer’s Disease) Trial: interim results after two years of treatment. J Alzheimers Dis. 2014;42(Suppl. 3):S281-8. DOI:10.3233/JAD-140150
22. Traini E, Carotenuto A, Fasanaro AM, Amenta F. Volume Analysis of Brain Cognitive Areas in Alzheimer’s Disease: Interim 3-Year Results from the ASCOMALVA Trial. J Alzheimers Dis. 2020;76(1):317-29. DOI:10.3233/JAD-190623
23. Kang M, Lee DB, Kwon S, et al. Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data. J Clin Med. 2022;11(16):4661. DOI:10.3390/jcm11164661
________________________________________________
2. Tkacheva ON, Runikhina NK, Ostapenko VS, et al. Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow. Clin Interv Aging. 2018;13:251-9. DOI:10.2147/CIA.S153389
3. Bogolepova AN, Vasenina EE, Gomzyakova NA, et al. Clinical Guidelines for Cognitive Disorders in Elderly and Older Patients. SS Korsakov Journal of Neurology and Psychiatry. 2021;121(10‑3):6‑137 (in Russian). DOI:10.17116/jnevro20211211036
4. Khenderson DzhM. Patofiziologiia organov pishchevareniia. Moscow: Binom; Saint Petersburg: Nevskii dialekt, 2019 (in Russian).
5. Baijens LW, Clavé P, Cras P, et al. European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016;11:1403-28. DOI:10.2147/CIA.S107750
6. Maniaci A, Lechien JR, La Mantia I, et al. Cognitive Impairment and Mild to Moderate Dysphagia in Elderly Patients: A Retrospective Controlled Study. Ear Nose Throat J. 2022;1455613211054631. DOI:10.1177/01455613211054631
7. Rajati F, Ahmadi N, Naghibzadeh ZA, Kazeminia M. The global prevalence of oropharyngeal dysphagia in different populations: a systematic review and meta-analysis. J Transl Med. 2022;20(1):175. DOI:10.1186/s12967-022-03380-0
8. Affoo RH, Foley N, Rosenbek J, et al. Swallowing dysfunction and autonomic nervous system dysfunction in Alzheimer’s disease: a scoping review of the evidence. J Am Geriatr Soc. 2013;61(12):2203-13. DOI:10.1111/jgs.12553
9. Mao L, Wang J, Li Y, et al. Risk factors for dysphagia in patients with acute and chronic ischemic stroke: A retrospective cohort study. Heliyon. 2024;10(2):e24582. DOI:10.1016/j.heliyon.2024.e24582
10. Alagiakrishnan K, Bhanji RA, Kurian M. Evaluation and management of oropharyngeal dysphagia in different types of dementia: a systematic review. Arch Gerontol Geriatr. 2013;56(1):1-9. DOI:10.1016/j.archger.2012.04.011
11. Michel A, Verin E, Hansen K, et al. Buccofacial Apraxia, Oropharyngeal Dysphagia, and Dementia Severity in Community-Dwelling Elderly Patients. J Geriatr Psychiatry Neurol. 2021;34(2):150-5. DOI:10.1177/0891988720915519
12. Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26(9):1256-65. DOI:10.1111/nmo.12382
13. Wolf U, Eckert S, Walter G, et al. Prevalence of oropharyngeal dysphagia in geriatric patients and real-life associations with diseases and drugs. Sci Rep. 2021;11(1):21955. DOI:10.1038/s41598-021-99858-w
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Авторы
В.С. Остапенко, Э.А. Мхитарян*
ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*melen99@mail.ru
Pirogov Russian National Research Medical University, Moscow, Russia
*melen99@mail.ru
ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*melen99@mail.ru
________________________________________________
Pirogov Russian National Research Medical University, Moscow, Russia
*melen99@mail.ru
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