The Role of Nutrition and Lifecare on Oropharyngeal Dysphagia

Dear Colleagues,

Oropharyngeal dysphagia is defined as a swallowing disorder where it becomes difficult to form a bolus and move food from the mouth to the proximal part of the esophagus; it is also recognized as a geriatric syndrome. Oropharyngeal dysphagia is a fairly common clinical condition, with a prevalence ranging from 2.3% to 16% in the general population, from 30% to 40% among the older people, and as high as 60% among people living in care facilities.

Most often, this condition occurs in people with neurological or muscle pathologies that affect skeletal muscles: Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, stroke, pseudobulbar palsy, dermatomyositis, myasthenia gravis, muscular dystrophy, head or neck cancer, xerostomia, and dementia, especially Alzheimer's disease.

This condition can lead to dehydration, malnutrition, and aspiration, which is associated with respiratory infections and aspiration penumonia. Oropharyngeal dysphagia also harms the lives of patients—it reduces self-confidence, affects social life, work, leisure time, and worsens the quality of life.

The complex treatment of oropharyngeal dysphagia plays an important role in improving the quality of life of people with this condition and reducing the risk of aspiration. Treatment methods aim to improve swallowing safety by changing food texture, fluid consistency, and/or feeding posture. Another part of the complex treatment is neuromuscular electrical stimulation and physical exercises that strengthen the swallowing muscles. In most cases, treatment has to last a lifetime; it forms part of the daily routine and affects people's quality of life. In order to prevent the deterioration of patients' quality of life and life-threatening complications, a special dysphagia severity scale and quality of life in dysphagia questionnaires can be used to assess these problems and their extent.

Until now, uncertainties remain regarding the treatment of oropharyngeal dysphagia and the quality of life of terminally ill people. Both patients with advanced dementia and their caregivers and the ethical aspects of artificial feeding in this life situation are a particularly sensitive area.

Considering all of these issues, this Special Issue of Nutrients, entitled "The Role of Nutrition and Lifecare on Oropharyngeal Dysphagia”, encourages researchers to submit articles that investigate the effectiveness of dietary modification options, the suitability of thickeners used in daily practice, the selection of swallowing muscle strengthening exercises suitable for people with dementia, and new eating and feeding self-monitoring tools that can detect the increased risk of aspiration. Articles in the field of dementia are especially welcome, including literature review articles, articles analyzing new quality of life questionnaires for dementia with dysphagia patients and their caregivers, and articles discussing the ethical aspects of artificial feeding of a patient suffering from advanced dementia with dysphagia.

Ultimately, research in this area can help to promote patient empowerment and the self-management of dysphagia. By identifying effective nutritional and behavioral interventions, patients and their caregivers can be empowered to take an active role in the long lasting treatment of oropharyngeal dysphagia themselves, which can lead to positive outcomes not only in terms of physical health and daily activities, but also in self-esteem and emotional well-being.

Prof. Dr. Gytė Damulevičienè
Guest Editor

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• oropharyngeal dysphagia
• modified diet
• thick fluids
• thickeners
• swallowing training
• hydration
• malnutrition
• oropharyngeal dysphagia on advanced dementia
• quality of life