Association between Dysphagia and Frailty in Older Adults: A Systematic Review and Meta-Analysis.

BACKGROUND: Increasing bodies of epidemiological evidence indicate potential associations between dysphagia and the risk of frailty in older adults. We hypothesized that older adults with symptoms of dysphagia might have a higher prevalence of frailty or prefrailty than those without dysphagia. METHODS: We systematically searched the PubMed, Embase, and Cochrane Library databases for relevant studies published through 20 April 2022. Cross-sectional and longitudinal studies that examined the associations between dysphagia and the existence of frailty or prefrailty in community-dwelling, facility-dwelling, or hospitalized adults aged 50 years or older were synthesized. The Newcastle-Ottawa Scale was used to evaluate study quality. RESULTS: The meta-analysis comprised 12 cohorts, including 5,503,543 non-frailty participants and 735,303 cases of frailty or prefrailty. Random-effect meta-analysis demonstrated a significant association between dysphagia and the risk of frailty and prefrailty (OR, 3.24; 95% CI, 2.51-4.20). In addition, we observed consistent results across the subgroups and heterogeneity assessments. CONCLUSIONS: We propose including dysphagia assessment as a critical factor in the cumulative deficit model for identifying frailty in older adults. Understanding dysphagia and the potential role of nutritional supplements in older adults may lead to improved strategies for preventing, delaying, or mitigating frailty.

Smart Restored by Learning Exercise Alleviates the Deterioration of Cognitive Function in Older Adults with Dementia-A Quasi-Experimental Research.

Maintaining cognitive function is essential for older adults with dementia. The purpose of this study was to investigate the effectiveness of Smart Restored by Learning Exercise (SRLE) on cognitive functions, neuropsychiatric symptoms, and frontal lobe functions in elderly people with dementia. A total of 68 older adults with dementia participated in this study. A quasi-experimental design was used, and convenience sampling and assignment approaches were adopted to select the participants for experimental and control groups. The experimental group engaged in SRLE for 6 months. The control group received routine care without SRLE. The participants' cognitive function, neuropsychiatric symptoms, and frontal lobe function at baseline were evaluated using the Mini-Mental State Examination (MMSE), Neuropsychiatry Inventory (NPI), and Frontal Assessment Battery (FAB), respectively, in month 3 and month 6. The Group by Time interaction was statistically significant for MMSE and FAB scores, which indicated the different group effects between months 3 and 6. The results also showed that the improvement of MMSE, NPI, and FAB scores in the SRLE group were significantly better than the control group (t = -5.99~4.90, p < 0.001) at both months 3 and 6. In conclusion, long-term facilities may provide residents with SRLE every day to prevent a decline in the residents' levels of cognitive function.

[Disaster nursing: one nurse's role and experience during the Fukushima Power Plant disaster following the Great East Japan Earthquake].

The Richter-scale 9.0 earthquake that struck Northeast Japan on March 11th, 2011 caused a tsunami that damaged the Fukushima No. 1 Power Plant and released enormous amounts of radiation into the environment. Many area residents were evacuated to several protected fallout shelters. Prior to the tsunami, Fukashima had around 505,760 residents over 65 years of age, comprising 24.9% of the city's pre-tsunami population of Fukushima (City of Fukushima, 2011). The high proportion of elderly contributed to difficulties encountered in evacuating and caring for Fukushima citizens in the immediate aftermath of the disaster. The first author participated in disaster relief efforts in two fallout shelters in Fukushima. This article was written to share her post-disaster care experience and learned knowledge with medical care professionals in Taiwan and other high earthquake risk areas. The article also offers guidelines on appropriate medical personnel response and behavior with regard to disaster response. We hope this experience-sharing offers positive suggestions for the future and facilitates improved disaster-care education in East Asia and enhanced international cooperation on disaster rescue.