Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: the IDDSI framework
Julie A. Y. Cichero,Peter Lam,Catriona M. Steele,Catriona M. Steele,Ben Hanson,Jianshe Chen,Roberto Oliveira Dantas,Janice Duivestein,Jun Kayashita,Caroline Lecko,Joseph Murray,Mershen Pillay,Mershen Pillay,Luis F. Riquelme,Luis F. Riquelme,Soenke Stanschus +15 more
TL;DR: The IDDSI Framework involves a continuum of 8 levels identified by numbers, text labels, color codes, definitions, and measurement methods and is recommended for implementation throughout the world.
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Abstract: Dysphagia is estimated to affect ~8% of the world’s population (~590 million people). Texture-modified foods and thickened drinks are commonly used to reduce the risks of choking and aspiration. The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded with the goal of developing globally standardized terminology and definitions for texture-modified foods and liquids applicable to individuals with dysphagia of all ages, in all care settings, and all cultures. A multi-professional volunteer committee developed a dysphagia diet framework through systematic review and stakeholder consultation. First, a survey of existing national terminologies and current practice was conducted, receiving 2050 responses from 33 countries. Respondents included individuals with dysphagia; their caregivers; organizations supporting individuals with dysphagia; healthcare professionals; food service providers; researchers; and industry. The results revealed common use of 3–4 levels of food texture (54 different names) and ≥3 levels of liquid thickness (27 different names). Substantial support was expressed for international standardization. Next, a systematic review regarding the impact of food texture and liquid consistency on swallowing was completed. A meeting was then convened to review data from previous phases, and develop a draft framework. A further international stakeholder survey sought feedback to guide framework refinement; 3190 responses were received from 57 countries. The IDDSI Framework (released in November, 2015) involves a continuum of 8 levels (0–7) identified by numbers, text labels, color codes, definitions, and measurement methods. The IDDSI Framework is recommended for implementation throughout the world.
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Citations
European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia
Rainer Dziewas,Emilia Michou,Emilia Michou,Michaela Trapl-Grundschober,Avtar Lal,Ethem Murat Arsava,Philip M.W. Bath,Pere Clavé,Jörg Glahn,Shaheen Hamdy,Sue Pownall,Antonio Schindler,Margaret Walshe,Rainer Wirth,David Wright,Eric Verin +15 more
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TL;DR: In this article, the authors developed guidelines to assist all members of the multidisciplinary team in their management of patients with post-stroke dysphagia (PSD), which increases the risk of complications, in particular aspiration pneumonia, malnutrition and dehydration.
Age-related changes to eating and swallowing impact frailty: aspiration, choking risk, modified food texture and autonomy of choice
TL;DR: Age-related changes to the eating and swallowing system, noting especially those that are relevant for frail elders, are highlighted and modified food textures that are most often recommended by clinicians to maintain sufficient oral intake and reduce choking risk will be described.
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Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review
Alessandro de Sire,Martina Ferrillo,Lorenzo Lippi,F. J. Agostini,Roberto de Sire,Paola Emilia Ferrara,G. Raguso,S. Riso,Andrea Roccuzzo,Gianpaolo Ronconi,Marco Invernizzi,Mario Migliario +11 more
TL;DR: The aim of the present comprehensive review is to describe the correlation among sarcopenic dysphagia, malnutrition, and oral frailty, characterizing their phenotypically overlapping features, to propose a comprehensive and effective management of elderly frail subjects.
Swallowing Disorders in the Older Population
TL;DR: This article discusses the complex process of swallowing in normal circumstances and with healthy aging, then reviews etiologies that contribute to dysphagia, and highlights the desperate need for high‐quality research to guide best practices in treating dysphagIA in older adults.
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Use of modified diets to prevent aspiration in oropharyngeal dysphagia: is current practice justified?
TL;DR: There is no good evidence to date that thickening liquids reduces pneumonia in dysphagia and this intervention may be associated with reduced fluid intake, so there is an urgent need for better quality evidence regarding this intervention.
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