치매 환자에서의 연하장애

Abstract

Dysphagia is a frequent problem in dementia as Alzheimer’s disease. Changes of swallowing function can be started even in the early stages of dementia. Structural and physiologic changes of oral/dental functions in the elderly underlies in persons with dementia. Cognitive based dysphagia is caused by impairment of consciousness and attention, memory, perception, and goal management related with feeding activities. Behavioral and psycholocal symptoms of dementia (BDSD) often results in dysphagia and eating disorders. Dysphagia in dementia should be approached individually. The goals of the program are the maintenance of the optimal nutrition and the prevention of complication such as aspiration pneumonia. Close observation by medical staffs and caregivers is the key to detect early signs of eating disorders in dementia patients. Assessment includes medical history, oral/dental function, swallowing function, and nutritional status. Sensory stimulation methods, adaptive equipment and utensil, diet modification, behavioral and environmental modification are the strategies for managing the problem. Enteral tube feeding is not proven to improve survival of end state dementia patients. (JKDS 2016;6:66-69)