KRONİK NÖROLOJİK HASTALIKLARDA BESLENME VE BESLENME DESTEĞİNİN ÖNEMİ

Yıl 2022, Cilt: 2 Sayı: 2, 50 - 60, 29.12.2022

Hilal Doğan Güney , Nevin Şanlıer

Öz

Yaşın ilerlemesiyle birlikte psikolojik, fizyolojik, sosyal ve bilişsel alanlarda değişiklikler oluşmakta ve bireyde kronik hastalıklar artmaktadır. Bu değişikliklerle seyreden 65 yaş ve üzeri bireyleri Dünya Sağlık Örgütü (DSÖ) yaşlılık dönemi olarak kabul etmektedir. Geriatrik bir hasta, spesifik olarak yaş ile tanımlı değildir, bunun yerine yüksek derecede kırılganlık ve 80 yaşın üzerindeki yaş grubunda daha yaygın hale gelen çoklu aktif hastalıklarla karakterizedirNörolojik hastalıkların etiyopatogenezi henüz tam olarak belli olmamakla birlikte; sosyal, çevresel, fizyolojik, anatomik, genetik, biyokimyasal ve diğer faktörlerin etiyolojide rol oynayabileceği düşünülmektedir. Ancak bu hastalıklar sıklıkla yutma bozuklukları ve yetersiz beslenme ile ilişkilendirilmektedir. Nörolojik hastalıkları olan hastalar yetersiz beslenmeye bağlı olarak makro ve mikro besin ögeleri eksikliği ve dehidrasyon riski altındadırlar. Orofaringeal disfaji, bilinç bozukluğu, bilişsel işlev bozukluğu vb. etkiler malnütrisyonun gelişmesine neden olabilmektedir. Nörolojik hastalıkları olan hastalarda tıbbi beslenme tedavisi önemlidir. Yaşlı bireylerde önemli bir sorun olan nörolojik hastalıklarda enerji, besin ögesi yetersizliği ve beslenememe önemli bir sorun olarak görülmektedir. Bu derleme amyotrofik lateral skleroz, parkinson hastalığı, inme, alzheimer ve multipl skleroz gibi kronik nörolojik hastalıklarda tıbbi beslenme tedavisi ile beslenme desteğinin önemini irdelemek ve konuya dikkat çekmek amacıyla planlanmış ve yürütülmüştür.

Anahtar Kelimeler

Beslenme, Malnutrisyon, Nörolojik Hastalıklar

Kaynakça

• 1. Dziewas, R., Beck, A. M., Clave, P., Hamdy, S., Heppner, H. J., Langmore, S. E., et al. (2017). Recognizing the importance of dysphagia: stumbling blocks and stepping stones in the twenty-first century. Dysphagia, 32(1), 78-82.
• 2. Hoffmann, S., Malzahn, U., Harms, H., Koennecke, H. C., Berger, K., Kalic, M., et al. (2012). Development of a clinical score (A2DS2) to predict pneumonia in acute ischemic stroke. Stroke, 43(10), 2617-2623.
• 3. Martino, R., Foley, N., Bhogal, S., Diamant, N., Speechley, M., & Teasell, R. (2005). Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke, 36(12), 2756-2763.
• 4. Suntrup, S., Warnecke, T., Kemmling, A., Teismann, I. K., Hamacher, C., Oelenberg, S., & Dziewas, R. (2012). Dysphagia in patients with acute striatocapsular hemorrhage. Journal of neurology, 259(1), 93-99.
• 5. Morgan, A. S., & Mackay, L. E. (1999). Causes and complications associated with swallowing disorders in traumatic brain injury. The Journal of head trauma rehabilitation, 14(5), 454-461.
• 6. Mackay, L. E., Morgan, A. S., & Bernstein, B. A. (1999). Factors affecting oral feeding with severe traumatic brain injury. The Journal of head trauma rehabilitation, 14(5), 435-447.
• 7. Müller, J., Wenning, G. K., Verny, M., McKee, A., Chaudhuri, K. R., Jellinger, K., et al. (2001). Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders. Archives of neurology, 58(2), 259-264.
• 8. Miller, N., Noble, E., Jones, D., & Burn, D. (2006). Hard to swallow: dysphagia in Parkinson’s disease. Age and ageing, 35(6), 614-618.
• 9. Guan, X. L., Wang, H., Huang, H. S., & Meng, L. (2015). Prevalence of dysphagia in multiple sclerosis: a systematic review and meta-analysis. Neurological Sciences, 36(5), 671-681.
• 10. Calcagno, P., Ruoppolo, G., Grasso, M. G., De Vincentiis, M., & Paolucci, S. (2002). Dysphagia in multiple sclerosis–prevalence and prognostic factors. Acta Neurologica Scandinavica, 105(1), 40-43.
• 11. Kühnlein, P., Gdynia, H. J., Sperfeld, A. D., Lindner-Pfleghar, B., Ludolph, A. C., Prosiegel, M.,et al. (2008). Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nature clinical practice Neurology, 4(7), 366-374.
• 12. Grob, D., Arsura, E. L., Brunner, N. G., & Namba, T. (1987). The course of myasthenia gravis and therapies affecting outcome. Annals of the New York Academy of Sciences, 505, 472-499.
• 13. Mulcahy, K. P., Langdon, P. C., & Mastaglia, F. (2012). Dysphagia in inflammatory myopathy: self-report, incidence, and prevalence. Dysphagia, 27(1), 64-69.
• 14. Tolep, K., Getch, C. L., & Criner, G. J. (1996). Swallowing dysfunction in patients receiving prolonged mechanical ventilation. Chest, 109(1), 167-172.
• 15. Macht, M., Wimbish, T., Clark, B. J., Benson, A. B., Burnham, E. L., Williams, A., & Moss, M. (2011). Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Critical care, 15(5), 1-9.
• 16. Wirth, R., Dziewas, R., Beck, A. M., Clavé, P., Hamdy, S., Heppner, H. J., et al. (2016). Oropharyngeal dysphagia in older persons–from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clinical interventions in aging, 11, 189.
• 17. Bischoff, S. C., Singer, P., Koller, M., Barazzoni, R., Cederholm, T., & Van Gossum, A. (2015). Standard operating procedures for ESPEN guidelines and consensus papers. Clinical Nutrition, 34(6), 1043-1051.
• 18. Wirth, R., Smoliner, C., Jäger, M., Warnecke, T., Leischker, A. H., & Dziewas, R. (2013). Guideline clinical nutrition in patients with stroke. Experimental & translational stroke medicine, 5(1), 1-11.
• 19. Gomes, F., Hookway, C., & Weekes, C. E. (2014). Royal C ollege of P hysicians I ntercollegiate S troke W orking P arty evidence‐based guidelines for the nutritional support of patients who have had a stroke. Journal of Human Nutrition and Dietetics, 27(2), 107-121.
• 20. Geeganage, C., Beavan, J., Ellender, S., & Bath, P. M. (2012). Interventions for dysphagia and nutritional support in acute and subacute stroke. Cochrane Database of Systematic Reviews, (10).
• 21. Sign, S. I. G. N. (2011). 50: A guideline developers' handbook. SIGN.
• 22. Cederholm, T., Barazzoni, R. O. C. C. O., Austin, P., Ballmer, P., Biolo, G. I. A. N. N. I., Bischoff, S. C., et al. (2017). ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical nutrition, 36(1), 49-64.
• 23. Couratier, P., Corcia, P., Lautrette, G., Nicol, M., Preux, P. M., & Marin, B. (2016). Epidemiology of amyotrophic lateral sclerosis: a review of literature. Revue neurologique, 172(1), 37-45.
• 24. Zhou, M., Wang, H., Zeng, X., Yin, P., Zhu, J., Chen, W.,et al. (2019). Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 394(10204), 1145-1158.
• 25. Chio, A., Logroscino, G., Hardiman, O., Swingler, R., Mitchell, D., Beghi, E., et al. (2009). Prognostic factors in ALS: a critical review. Amyotrophic lateral sclerosis, 10(5-6), 310-323.
• 26. Desport, J. C., Marin, B., Funalot, B., Preux, P. M., & Couratier, P. (2008). Phase angle is a prognostic factor for survival in amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis, 9(5), 273-278.
• 27. Marin, B., Desport, J. C., Kajeu, P., Jésus, P., Nicolaud, B., Nicol, M., et al. (2011). Alteration of nutritional status at diagnosis is a prognostic factor for survival of amyotrophic lateral sclerosis patients. Journal of Neurology, Neurosurgery & Psychiatry, 82(6), 628-634.
• 28. Marin, B., Arcuti, S., Jesus, P., Logroscino, G., Copetti, M., Fontana, A., et al. (2016). Population-based evidence that survival in amyotrophic lateral sclerosis is related to weight loss at diagnosis. Neurodegenerative diseases, 16(3-4), 225-234.
• 29. Bouteloup, C., Desport, J. C., Clavelou, P., Guy, N., Derumeaux-Burel, H., Ferrier, A., & Couratier, P. (2009). Hypermetabolism in ALS patients: an early and persistent phenomenon. Journal of neurology, 256(8), 1236-1242.
• 30. Chiò, A., Calvo, A., Bovio, G., Canosa, A., Bertuzzo, D., Galmozzi, F., et al. (2014). Amyotrophic lateral sclerosis outcome measures and the role of albumin and creatinine: a population-based study. JAMA neurology, 71(9), 1134-1142.
• 31. Dupuis, L., Corcia, P., Fergani, A., De Aguilar, J. L. G., Bonnefont-Rousselot, D., Bittar, R., ... & Meininger, V. (2008). Dyslipidemia is a protective factor in amyotrophic lateral sclerosis. Neurology, 70(13), 1004-1009.
• 32. Rafiq, M. K., Lee, E., Bradburn, M., McDermott, C. J., & Shaw, P. J. (2015). Effect of lipid profile on prognosis in the patients with amyotrophic lateral sclerosis: insights from the olesoxime clinical trial. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 16(7-8), 478-484.
• 33. Dorst, J., Kühnlein, P., Hendrich, C., Kassubek, J., Sperfeld, A. D., & Ludolph, A. C. (2011). Patients with elevated triglyceride and cholesterol serum levels have a prolonged survival in amyotrophic lateral sclerosis. Journal of neurology, 258(4), 613-617.
• 34. Desport, J. C., Preux, P. M., Truong, T. C., Vallat, J. M., Sautereau, D., & Couratier, P. (1999). Nutritional status is a prognostic factor for survival in ALS patients. Neurology, 53(5), 1059-1059.
• 35. Paganoni, S., Deng, J., Jaffa, M., Cudkowicz, M. E., & Wills, A. M. (2011). Body mass index, not dyslipidemia, is an independent predictor of survival in amyotrophic lateral sclerosis. Muscle & nerve, 44(1), 20-24.
• 36. Rio, A., Ellis, C., Shaw, C., Willey, E., Ampong, M. A., Wijesekera, L., ... & Al‐Chalabi, A. (2010). Nutritional factors associated with survival following enteral tube feeding in patients with motor neurone disease. Journal of human nutrition and dietetics, 23(4), 408-415.
• 37. Shimizu, T., Nagaoka, U., Nakayama, Y., Kawata, A., Kugimoto, C., Kuroiwa, Y., et al. (2012). Reduction rate of body mass index predicts prognosis for survival in amyotrophic lateral sclerosis: a multicenter study in Japan. Amyotrophic Lateral Sclerosis, 13(4), 363-366.
• 38. Roubeau, V., Blasco, H., Maillot, F., Corcia, P., & Praline, J. (2015). Nutritional assessment of amyotrophic lateral sclerosis in routine practice: value of weighing and bioelectrical impedance analysis. Muscle & nerve, 51(4), 479-484.
• 39. Desport, J. C., Preux, P. M., Bouteloup-Demange, C., Clavelou, P., Beaufrère, B., Bonnet, C., & Couratier, P. P. (2003). Validation of bioelectrical impedance analysis in patients with amyotrophic lateral sclerosis. The American journal of clinical nutrition, 77(5), 1179-1185.
• 40. Vaisman, N., Lusaus, M., Nefussy, B., Niv, E., Comaneshter, D., Hallack, R., & Drory, V. E. (2009). Do patients with amyotrophic lateral sclerosis (ALS) have increased energy needs?. Journal of the neurological sciences, 279(1-2), 26-29.
• 41. Weijs, P. J. (2011). Hypermetabolism, is it real? The example of amyotrophic lateral sclerosis. Journal of the American Dietetic Association, 111(11), 1670.
• 42. Sherman, M. S., Pillai, A., Jackson, A., & Heiman‐Patterson, T. (2004). Standard equations are not accurate in assessing resting energy expenditure in patients with amyotrophic lateral sclerosis. Journal of Parenteral and Enteral Nutrition, 28(6), 442-446.
• 43. Kasarskis, E. J., Mendiondo, M. S., Matthews, D. E., Mitsumoto, H., Tandan, R., Simmons, Z., et al. (2014). Estimating daily energy expenditure in individuals with amyotrophic lateral sclerosis. The American journal of clinical nutrition, 99(4), 792-803.
• 44. Ellis, A. C., & Rosenfeld, J. (2011). Which equation best predicts energy expenditure in amyotrophic lateral sclerosis?. Journal of the American Dietetic Association, 111(11), 1680-1687.
• 45. Genton, L., Viatte, V., Janssens, J. P., Héritier, A. C., & Pichard, C. (2011). Nutritional state, energy intakes and energy expenditure of amyotrophic lateral sclerosis (ALS) patients. Clinical nutrition, 30(5), 553-559.
• 46. Salvioni, C. C. D. S., Stanich, P., Almeida, C. S., & Oliveira, A. S. B. (2014). Nutritional care in motor neurone disease/amyotrophic lateral sclerosis. Arquivos de Neuro-psiquiatria, 72, 157-163.
• 47. Georges, M., Morélot-Panzini, C., Similowski, T., & Gonzalez-Bermejo, J. (2014). Noninvasive ventilation reduces energy expenditure in amyotrophic lateral sclerosis. BMC Pulmonary Medicine, 14(1), 1-8.
• 48. Siirala, W., Olkkola, K. T., Noponen, T., Vuori, A., & Aantaa, R. (2010). Predictive equations over-estimate the resting energy expenditure in amyotrophic lateral sclerosis patients who are dependent on invasive ventilation support. Nutrition & Metabolism, 7(1), 1-7.
• 49. Shimizu, T., Hayashi, H., & Tanabe, H. (1991). Energy metabolism of ALS patients under mechanical ventilation and tube feeding. Rinsho shinkeigaku= Clinical neurology, 31(3), 255-259.
• 50. Ichihara, N., Namba, K., Ishikawa-Takata, K., Sekine, K., Takase, M., Kamada, Y., et al. (2012). Energy requirement assessed by doubly-labeled water method in patients with advanced amyotrophic lateral sclerosis managed by tracheotomy positive pressure ventilation. Amyotrophic Lateral Sclerosis, 13(6), 544-549.
• 51. Clavelou, P., Blanquet, M., Peyrol, F., Ouchchane, L., & Gerbaud, L. (2013). Rates of progression of weight and forced vital capacity as relevant measurement to adapt amyotrophic lateral sclerosis management for patient Result of a French multicentre cohort survey. Journal of the Neurological Sciences, 331(1-2), 126-131.
• 52. Chiò, A., Finocchiaro, E., Meineri, P., Bottacchi, E., Schiffer, D., & ALS Percutaneous Endoscopic Gastrostomy Study Group. (1999). Safety and factors related to survival after percutaneous endoscopic gastrostomy in ALS. Neurology, 53(5), 1123-1123.
• 53. Héritier, A. C., Janssens, J. P., Adler, D., Ferfoglia, R. I., & Genton, L. (2015). Should patients with ALS gain weight during their follow-up?. Nutrition, 31(11-12), 1368-1371.
• 54. Miller, R. G., Jackson, C. E., Kasarskis, E. J., England, J. D., Forshew, D., Johnston, W., et al. (2009). Practice parameter update: the care of the patient with amyotrophic lateral sclerosis: drug, nutritional, and respiratory therapies (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 73(15), 1218-1226.
• 55. Dorst, J., Cypionka, J., & Ludolph, A. C. (2013). High-caloric food supplements in the treatment of amyotrophic lateral sclerosis: a prospective interventional study. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 14(7-8), 533-536.
• 56. EFNS Task Force on Diagnosis and Management of Amyotrophic Lateral Sclerosis:, Andersen, P. M., Abrahams, S., Borasio, G. D., de Carvalho, M., Chio, A., et al. (2012). EFNS guidelines on the clinical management of amyotrophic lateral sclerosis (MALS)–revised report of an EFNS task force. European journal of neurology, 19(3), 360-375.
• 57. Ruoppolo, G., Schettino, I., Frasca, V., Giacomelli, E., Prosperini, L., Cambieri, C.,et al. (2013). Dysphagia in amyotrophic lateral sclerosis: prevalence and clinical findings. Acta Neurologica Scandinavica, 128(6), 397-401.
• 58. Hillel, A. D., & Miller, R. (1989). Bulbar amyotrophic lateral sclerosis: patterns of progression and clinical management. Head & neck, 11(1), 51-59.
• 59. Valadi, N. (2015). Evaluation and management of amyotrophic lateral sclerosis. Primary Care: Clinics in office practice, 42(2), 177-187.
• 60. Greenwood, D. I. (2013). Nutrition management of amyotrophic lateral sclerosis. Nutrition in clinical practice, 28(3), 392-399.