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Published on: March 1, 2015
Swallowing Dynamics and Breathing-Swallowing Coordination Are Altered in Patients with Mild Cognitive Impairment
Yoshitaka Oku1,2, Naomi Yagi1,3, Madoka Nishino4
1Department of Physiology, Hyogo College of Medicine, Nishinomiya, Japan.
Introduction:
Postinspiratory activity, which is essential for laryngeal closure during swallowing to prevent aspiration of food into the airways, is reduced in a mouse model of tauopathy. Therefore, we hypothesized that patients at the stage of mild cognitive impairment (MCI) exhibit alterations in swallowing dynamics and coordination between swallowing and breathing.
Methods:
We examined breathing-swallowing coordination in patients with MCI. Patients who scored ≥24 on the Mini-Mental State Examination and <26 on the Japanese version of the Montreal Cognitive Assessment were recruited at Sumoto Itsuki Hospital. Parameters associated with breathing-swallowing coordination were assessed using a combination of two sensors: a respiratory flow sensor and a piezoelectric sensor attached to the skin surface of the anterior neck.
Results:
Nineteen patients met the criteria for MCI; 16 of these patients (79.5 ± 9.1 years old) scored <3 on the 10-item Eating Assessment Tool and were enrolled in the study. Their data were compared with those of an age-matched elderly cohort (79.9 ± 2.9 years old). The frequencies of swallowing during inspiration and swallowing immediately followed by inspiration in patients with MCI were 6.9% and 9.6%, respectively; these frequencies were not significantly different from those of the age-matched elderly cohort. However, the timing of swallowing in the respiratory cycle was significantly delayed in the MCI patients, and both time from the onset to the peak of laryngeal elevation and the duration between the onset of rapid laryngeal elevation and the time when the larynx returned to the resting position were significantly lengthened in this group.
Conclusion:
At the stage of MCI, breathing-swallowing coordination has already started to decline.
Insights
Mild cognitive impairment (MCI) patients show delayed swallowing timing and prolonged laryngeal elevation during breathing-swallowing coordination. This indicates an early decline in these crucial functions even at the MCI stage.
Area of Science:
- Neurology
- Gerontology
- Speech and Hearing Science
Background:
- Swallowing requires precise laryngeal closure to prevent aspiration.
- Reduced postinspiratory activity in a mouse model of tauopathy suggests potential swallowing deficits in related human conditions.
- Mild cognitive impairment (MCI) may impact swallowing dynamics and breathing-swallowing coordination.
Purpose of the Study:
- To investigate alterations in swallowing dynamics and breathing-swallowing coordination in patients with mild cognitive impairment (MCI).
Main Methods:
- Breathing-swallowing coordination was assessed in MCI patients and an age-matched elderly cohort.
- Utilized a respiratory flow sensor and a piezoelectric sensor on the neck.
- Included patients meeting MCI criteria (MMSE ≥24, MoCA-J <26) and assessed with the Eating Assessment Tool.
Main Results:
- MCI patients exhibited significantly delayed swallowing timing within the respiratory cycle.
- Laryngeal elevation onset to peak time and duration were significantly prolonged in MCI patients.
- No significant difference in the frequency of swallowing during or immediately after inspiration was observed between groups.
Conclusions:
- Breathing-swallowing coordination begins to decline at the mild cognitive impairment (MCI) stage.
- MCI is associated with altered timing and duration of laryngeal movements during swallowing.
- Early detection of these swallowing changes may be crucial for managing MCI.
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