43㫽 ྲྀ ⮫ ᗋ ⛉ Ꮫ 12(1), 43-50, 2020

ඛ ⾜ ᮇ ࡟ ࠾ ࡅ ࡿ ᩱ ⌮ ࡢ DVD ど ⫈ ࡜ ໝ ࠸ ࡢ ࣏ ࢪ ࢸ ࢕ ࣈ ௓ ධ ࡟ ࡼ ࡿၚᾮ㔞࡜ᄟୗᅇᩘࡢኚ໬㎷ ᮧ ⫕ 1, 3) ⁪ ᮏ ᑗ ኱ 3) ᑠ す ྜྷ ⿱ 2) እ ụ ග 㞝 1) ᯇ ᮧ 㞞 ྐ 3)
1) ࡧ ࢃ ࡇ ࣜ ࣁ ࣅ ࣜ ࢸ ࣮ ࢩ ࣙ ࣥ ᑓ 㛛 ⫋ ኱ Ꮫ స ᴗ ⒪ ἲ Ꮫ ⛉2) NHO 㫽 ྲྀ ་ ⒪ ࢭ ࣥ ࢱ ࣮ ⮫ ᗋ ◊ ✲ 㒊3) ኱ 㜰 㟁 Ẽ ㏻ ಙ ኱ Ꮫ ་ ⒪ ೺ ᗣ ⛉ Ꮫ 㒊Changes in saliva secretion and swallowing frequency through positive
interventions using a DVD and scents at the anticipatory stage

Hajime Tsujimura 1 , 3 ) Shota Takimoto 3 ) Yoshihiro Konishi 2 ) Mitsuo Tonoike 1 )Masafumi Matsumura 3 )1) Department of Occupational Therapy,
Biwako Professional University of Rehabilitation
2) Department of Clin ical Research, NHO Tottori Medical Center3) Department of Medical and Health Sciences,
Osaka Electro-Communication University

せ᪨ᮏ◊✲ࡣ, ࣇࣞ࢖ࣝண㜵࡟࠾ࡅࡿపᰤ㣴ᑐ⟇࡜ࡋ࡚, 㧗㱋⪅ࡢᄟୗᶵ⬟ࡢ⥔ᣢ࣭ྥୖࢆ┠ᣦࡋࡓࡶࡢ࡛࠶ࡿ. 㧗㱋⪅ࡀపᰤ㣴≧ែ࡜࡞ࡿᵝࠎ࡞ཎᅉࡢ୰࡟ࡣ , ࿪ᄮ࣭ᄟୗᶵ⬟పୗ࡟㛵㐃ࡋࡓ㣗஦㔞ࡢῶᑡ, 㣗஦ෆᐜࡸᙧែࡢኚ᭦࡟ࡼࡿ㣗ḧࡢῶ㏥ࡀ࠶ࡿ. ᰤ㣴≧ែࡢపୗࡣ, ࣇࣞ࢖ࣝ࡜࡞ࡾ, せ௓ㆤ≧ែ࡜࡞ࡿࣜࢫࢡࢆ㧗ࡵ, ⑌⑓ࡢⓎ⑕ࡸᝏ໬ࢆࡶࡓࡽࡍ. ࡇࡢᄟୗᶵ⬟ࡢపୗࡣ, ຍ㱋࡟ࡼࡿࡶࡢࡔࡅ࡛࡞ࡃ, ౑ࢃ࡞࠸ࡇ࡜ࡸ౑࠺㢖ᗘࡀᑡ࡞࠸ሙྜ࡟⏕ࡌࡿᗫ⏝ᛶⴎ⦰ࡀཎᅉ࡜࡞ࡿሙྜࡀ࠶ࡾ, ㄗᄟ࡜࠸ࡗࡓ⏕࿨࡟┤⤖ࡍࡿ஦ᨾ࡟⧅ࡀࡿ.
௒ᅇࡣ, ၚᾮቑຍ࡟ࡼࡾᄟୗ᫬㛫㛫㝸ࡀ▷⦰㸦ᄟୗᅇᩘቑຍ㸧ࡍࡿ࡜࠸࠺ඛ⾜◊✲ࡢ⤖ ᯝ ࢆ ㋃ ࡲ ࠼ , ᦤ 㣗 ࣭ ᄟ ୗ ࡢ ඛ ⾜ ᮇ ࡟ DVD ࡢ ど ⫈ ࡜ ໝ ࠸ ࡢ ࣏ ࢪ ࢸ ࢕ ࣈ ௓ ධ ࢆ ⾜ ࡗ ࡓ . ࡑ144ࡋ࡚, 㣗஦ࡢどぬ࡜Ⴅぬࡢࡑࢀࡒࢀࡢㄆ▱࡟ࡼࡿᄟୗ᫬㛫㛫㝸ኚ໬࡜ཱྀ⭍ෆỈศ㔞ࡢศᯒࢆ⾜࠸, ඛ⾜ᮇ࡟࠾ࡅࡿ㣗஦௓ຓ᫬ࡢどぬ࡜Ⴅぬࡢ࢔ࣉ࣮ࣟࢳࡢᚲせᛶ, ࠾ࡼࡧᗫ⏝ᛶ ⴎ ⦰ ࢆ ᅇ 㑊 ࡍ ࡿ ྍ ⬟ ᛶ ࢆ ᐇ ド ࡋ ࡓ . 㫽 ྲྀ ⮫ ᗋ ⛉ Ꮫ 12(1), 43-50, 2020
Abstract
This study aimed to maintain and enhance swallowing functions in elderly individuals forthe prevention of undernutrition and frailty. Several factors contribute to the onset ofundernutrition in elderly individuals. These include insufficient food intake associated withdecreased masticatory and swallowing functions as well as decreased appetite related tochanges in diet and food textures. Undernutrition increases the risk of frailty, long-term care,and ultimately the onse t and progression of diseases.
Decreased swallowing functions are associated with not only aging but also disuse atrophythat occurs due to little or no exercise of these functions. Poor swallowing functions cause alife-threatening event, such as aspiration.
A previous study reported that increased salivary secretion decreases swallowing timeintervals (i.e., increased swallowing frequency). Based on such findings, positive interventions
using a DVD and scents were performed at the anticipatory stage of the five stages of ingestionand swallowing. We analyzed whether understanding the sigh t and scents of meals is associatedwith changes in swallowing time intervals and intraoral moisture. The result demonstrated thatappeal to the visual and olfactory senses are needed at the time of meal support, and suchprocedure may prevent disuse atrophy. Tottori J. Clin. Res. 12(1), 43-50, 2020
Key words: ࣇ ࣞ ࢖ ࣝ , ᄟ ୗ ᶵ ⬟ , ᦤ 㣗 ࣭ ᄟ ୗ ࡢ ඛ ⾜ ᮇ , ೺ ᗣ ᑑ ࿨ , 㧗 㱋 ⪅ ࡢ ప ᰤ 㣴 ≧ ែ ;frailty, swallowing functions, the anticipatory stage of the five stages of ingestion andswallowing, healthy life expectancy, elderly individuals with undernutrition
პ. ࡣ ࡌ ࡵ ࡟ே ཱྀ ࡢ 28.4%ࢆ ༨ ࡵ , 3588 ୓ 5 ༓ ே ࡜ ࡞ ࡗࣇ ࣞ ࢖ ࣝ 1) ࡜ ࡣ , せ ௓ ㆤ ≧ ែ ࡟ ⮳ ࡿ ๓࡚ ࠸ ࡿ . ࡲ ࡓ ㏆ ᖺ ࡣ , ୡ ᖏ ᵓ 㐀 ࡣ 65 ṓ ௨ẁ 㝵 ࡛ , ⪁ ໬ ࡟ క ࠺ ✀ ࠎ ࡢ ᶵ ⬟ ప ୗ㸦 ண ഛୖࡢ༢㌟ୡᖏࡀቑຍࡋ࡚࠸ࡿ.

⬟ ຊ ࡢ ప ୗ 㸧ࢆ ᇶ ┙ ࡜ ࡋ , ᵝ ࠎ ࡞ ೺ ᗣ 㞀 ᐖ㧗㱋⪅ࡢ⏕ά⎔ቃࡸ⤒῭㠃, ⏕ά⠊ᅖ࡟ᑐࡍࡿ⬤ᙅᛶࡀቑຍࡋ࡚࠸ࡿ≧ែ࡜ࡉࡢ⦰ᑠ࡟ࡼࡿάື㔞ࡢపୗࡣ, ೫ࡗࡓᰤࢀ࡚࠸ࡿ. పᰤ㣴࡜ࣇࣞ࢖ࣝ࡜ࡢ㛵㐃ᛶ㣴ࡸ㣗ḧࡢపୗࢆᣍࡃ. ࡲࡓ㧗㱋⪅ࡣ,ࡣ㧗ࡃ, ೺ᗣᑑ࿨ࡢᘏఙࢆ┠ⓗ࡜ࡍࡿ㧗࿪ᄮ࣭ᄟୗᶵ⬟ࡢపୗࡸ⑌ᝈ࡞࡝࡟ࡼࡾ,㱋⪅ࡢపᰤ㣴㜵Ṇ, 㔜⑕໬ண㜵➼ࡢࣇࣞ㣗஦ෆᐜࡸᙧែࡢኚ᭦ࢆవ൤࡞ࡃࡉࢀ,. 2019 ᖺ㣗ḧࡀῶ㏥ࡍࡿሙྜࡀ࠶ࡿ. ᵝࠎ࡞≧ἣ࡟㛤ദࡉࢀࡓࠕ᪥ᮏேࡢ㣗஦ᦤྲྀᇶ‽ࠖୗ࡛㉳ࡇࡾࡸࡍ࠸㧗㱋⪅ࡢపᰤ㣴≧ែࡣ,࡟࠾࠸࡚ࡶ, ⺮ⓑ㉁ᦤྲྀ㔞➽ຊࡸㄆ▱ᶵ⬟ࡢపୗ, ឤᰁ⑕ࡸ⑌⑓ࡢ࢖ࣝᑐ⟇஦ᴗࡀ㐍ࡵࡽࢀ࡚࠸ࡿ⟇ᐃ᳨ウ఍4)2)ࡀ㦵᱁➽㔞, ➽ຊ, ㌟యᶵ⬟࡜῝ࡃ㛵㐃ࡀ࠶ࡿࡇ࡜࡛,Ⓨ⑕ࣜࢫࢡࢆ㧗ࡵࡿ.

65 ṓ ௨ ୖ ࡢ ⺮ ⓑ ㉁ ᦤ ྲྀ 㔞ࡲࡓ, ຍ㱋࡟ࡼࡿႃ㢌఩⨨ࡢୗᆶࡸၚࡢ┠ᶆ㔞ࡢୗ㝈ࡀᘬࡁୖࡆࡽࢀ࡚࠸ࡿ.

ᾮ㔞ࡢపୗࡣ, ᄟୗᶵ⬟ࢆపୗࡉࡏ, ᰤ୍ ᪉ , ᡃ ࡀ ᅜ ࡢ 2019 ᖺ ᗘ ࡢ 65 ṓ ௨ ୖ㣴≧ែࡔࡅ࡛࡞ࡃㄗᄟࡢࣜࢫࢡࢆ㧗ࡵࡿ.

࡟ࡼࡿ࡜⥲ࡉࡽ࡟, ᄟୗᶵ⬟ࡢపୗࡣᗫ⏝ᛶⴎ⦰࡟ࡢ㧗㱋⪅ࡣ, ⥲ົᒁ⤫ィᒁ5)2