Clinical trial NCT05734586: Screening for Sarcopenic Dysphagia and the Implementation of Measures to Prevent Its Complications in Geriatric Patients [DYSPHAGING-PILOT]
Official title: Feasibility Study of Screening for Sarcopenic Dysphagia and the Implementation of Measures to Prevent Its Complications in Geriatric or Institutionalized Patients Aged ≥ 70 Years.
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Swallowing Disorder
Sarcopanic Dysphagia
Keywords: Prevention
Nutrition
Re-education
Lead sponsor: Hospices Civils de Lyon
Sponsor class: OTHER
First posted: 2023-02-21
Enrollment: 102
Sex: ALL
Minimum age (years): 70
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: OTHER

Brief summary: Sarcopenic dysphagia is described as a swallowing disorder caused by a loss of muscle mass and strength, sarcopenia. It induces chronic complications like micro-inhalations and the worsening of chronic undernutrition, according to a vicious circle. Awareness of the high prevalence of sarcopenic dysphagia and its serious consequences among elderly people with disabilities and hospitalized patients is recent, which explains the low rate of screening in the population concerned. In this context, methods of prevention, evaluation and intervention of sarcopenic dysphagia adapted to the most exposed population are needed.

Two European learned societies have developed recommendations that include increased awareness of swallowing disorders, the use of screening scores, preventive measures, diagnostic standardization, and implemented interventions (rehabilitation, textural adaptation, etc.). In order to respect these recommendations, a pedagogical sheet, entitled DYSPHAGING was elaborated within our unit in a multiprofessional way in 4 steps (1 - Screen; 2 - Protect; 3 - Confirm; 4 - Rehabilitate).

This feasibility study aims to evaluate the rate of completion and the conditions for implementing steps 1 and 2 in hospital and institutional care units.

Detailed description: Sarcopenic dysphagia is described as a swallowing disorder caused by a loss of muscle mass and strength, sarcopenia. It induces chronic complications like micro-inhalations and the worsening of chronic undernutrition, according to a vicious circle. Awareness of the high prevalence of sarcopenic dysphagia and its serious consequences among elderly people with disabilities and hospitalized patients is recent, which explains the low rate of screening in the population concerned. In this context, methods of prevention, evaluation and intervention of sarcopenic dysphagia adapted to the most exposed population are needed.

Two European learned societies have developed recommendations that include increased awareness of swallowing disorders, the use of screening scores, preventive measures, diagnostic standardization, and implemented interventions (rehabilitation, textural adaptation, etc.). In order to respect these recommendations, a pedagogical sheet, entitled DYSPHAGING was elaborated within our unit in a multiprofessional way in 4 steps (1 - Screen; 2 - Protect; 3 - Confirm; 4 - Rehabilitate).

This feasibility study aims to evaluate the rate of completion and the conditions for implementing steps 1 and 2 in hospital and institutional care units.

Eligibility criteria: Inclusion Criteria:

* Patient aged ≥ 70 years,
* Patient affiliated to a social security system,
* Patient hospitalized in the health sector or in a medico-social institute,
* Patient informed of the study (information leaflet provided) and having orally signified their consent to inclusion in the study.
* Patient under legal protection, guardianship or curatorship,

Exclusion Criteria:

* Patient unable to feed orally,
* Patient with an active pathology responsible for acute swallowing disorders (\< 3 months) (neurodegenerative pathology with predominant motor impairment such as Charcot's disease, stroke, ENT disease).
* Patient unable to answer the questionnaire.

Primary outcomes:
measure: Proportion of complete achievement of steps 1 and 2
timeFrame: Three days
Secondary outcomes:
measure: Percentage of eligible patients refusing to participate in the study
timeFrame: 18 months
measure: Age, gender, comorbidities (CIRS-G), autonomy (ADL, IADL), co-medications
timeFrame: 19 months
measure: Rate of partial completion of the protocol
timeFrame: 19 months
measure: Diagnosis of undernutrition and/or neurocognitive disorders and/or patent lung infection and/or COPD described in the patient's medical file, nutritional risk situation assessed by the Mini Nutritional Assessment® (MNA)
timeFrame: 19 months
measure: Composition and disciplines of the care team
timeFrame: 19 months
measure: Caregiver satisfaction (Likert scale).
timeFrame: 19 months
Other outcomes:
Locations:
city: Lyon
country: France
facility: Centre Hospitalier Lyon Sud - Court Séjour Gériatrique
Study officials:
References: