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Abstract Introduction: Globally, the increasing prevalence of dysphagia necessitates improved management techniques. Dysphagia management is hindered by patient non-compliance due to the undesirable traits of texture-modified diets. 3D food printing (3DFP) may enhance the sensory appeal and nutritional content of these diets, but its practical application in clinical settings is still uncertain. This narrative review examines the factors affecting 3DFP implementation in dysphagia management using a multi-level framework. Methods: Five databases (PubMed, Embase, Web of Science, Scopus, and CINAHL) were searched from 2007 to March 2024, employing forward and backward snowballing to include additional sources such as theses and book chapters. Qualitative content analysis was used to analyze the implementation factors, including innovation, patient, provider, and organizational and structural factors. Within each factor, an inductive approach was applied to formulate subcategories. Results: The review included 72 articles, with the majority being laboratory-based. The innovation factor dominated, appearing in 86% of articles and encompassing advancements of food, post-processing consistency, food safety, and development needs. Both patient and provider factors, highlighted in 21% of articles, included seven subcategories each, encompassing potential uses, product issues, device usability, training needs, time and cost implications, and food safety. Organizational and structural factors, covered in 29% of articles, included potential benefits, food compliance, costs, safety, and development needs. Discussion/Conclusion: The use of 3DFP could significantly improve the visual and nutritional quality of dysphagia diets, enhancing patient satisfaction and providing a therapeutic tool for providers. However, its implementation faces challenges, including technology limitations, food quality, safety concerns, and integration into existing healthcare systems. Future research should expand clinical trials, improve food quality, address safety, and enhance 3DFP device functionality, while exploring cost-effective solutions and advancing material and printing technologies. This could dramatically improve dysphagia management and the quality of life for patients.

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Background Sarcopenic dysphagia is a swallowing disorder resulting from sarcopenia, which affects both the whole-body skeletal muscles and the muscles involved in swallowing. This scoping review aimed to characterize sarcopenic dysphagia and discuss its prevalence. Methods We searched PubMed, Embase, Cochrane Central, CINAHL, Scopus, Web of Science, ICTPR, and Clinical Trials in March 2024, using the search terms “(sarcopenia) and (dysphagia or deglutition disorders or esophageal achalasia or swallow OR esophageal dysmotility or nutcracker esophagus or dysphagia or eat or drink or odynophagia or deglutition or esophageal or esophageal or esophageal disorders)”. Articles including definition, prevalence, and diagnostic criteria of sarcopenic dysphagia were included. Results Eleven articles were included in this study addressing the definition, prevalence, and diagnostic criteria of sarcopenic dysphagia. All studies diagnosed sarcopenic dysphagia by individually assessing sarcopenia and dysphagia. Sarcopenia was assessed following the consensus guidelines from the Asia Working Group for Sarcopenia (AWGS) 2014 or 2019 or the European Working Group on Sarcopenia in Older People (EWGSOP) consensus from 2010 or 1019. For diagnosing dysphagia, various assessment tools were utilized to measure the swallowing muscle mass, strength, and function. Specifically, ultrasonography was employed to measure swallowing muscle mass; lingual strength was assessed using the Iowa Oral Performance Instrument (IOPI) or the JMS device; and muscle function was evaluated using Videofluoroscopy Swallowing study (VFSS), and surface Electromyography(sEMG). Conclusions Individual diagnostic criteria emerged as the prominent method for diagnosing primary sarcopenic dysphagia. Given the established consensus for diagnosing sarcopenia, and standardization is imperative for the diagnosis of dysphagia. Keywords Sarcopenia · Dysphagia·

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Introduction Head and neck cancer (HNC) ranks as the 7th most prevalent cancer globally, with radiotherapy (RT), with or without concurrent chemotherapy (C/RT), emerging as a preferred treatment approach for patients with locally advanced HNC. As a result of radiation, changes in swallowing function may result in radiation-associated dysphagia (RAD) as an acute side effect during treatment and may persist months to even years after treatment. However, there is limited understanding of the pathophysiology of swallowing in patients receiving primary C/RT for HNC. This retrospective cohort study aims to characterize the influence of primary C/RT treatment for HNC on the biomechanics of swallowing using pharyngeal high-resolution manometry with impedance (pHRMI). Materials and Methods We investigated 14 patients with HNC who underwent primary C/RT and simultaneous pHRMI and VFSS studies at a tertiary university hospital. Pharyngeal pressure and impedance recordings were obtained from each patient and analyzed using pressure-flow analysis (PFA) on Swallow GatewayTM. The pHRMI metrics for pharyngeal contractility, UES function, and flow timing were derived from PFA. To account for inherent differences in metrics based on bolus consistency and volume, these metrics were compared to normative values and across different volumes and consistencies. The influence of aspiration status, tumor characteristics and treatment on the PFA metrics were also explored. Results The results proved that HNC patients showed an incomplete UES relaxation and pressurization for both liquid and semi-solid swallows compared to healthy individuals. Furthermore, comparisons between different volumes and consistencies highlighted the significant roles of mesopharyngeal weakness, UES relaxation time, UES opening and bolus flow timing in the adaptations of swallow biomechanics as a result of primary radiation therapy for HNC. In addition, an incomplete UES relaxation was seen in patients who aspirated, who underwent radiotherapy with or without chemotherapy and who experienced RAD in the acute, chronic, and late stages. Conclusions Based on the current findings, it can be inferred that HNC patients who underwent primary C/RT demonstrate altered swallowing biomechanics. When analyzing pHRM in HNC patients, changes in pressure, impedance, and duration as a result of radiation may occur, indicating insufficient movement of swallowing structures, leading to reduced efficiency and safety of bolus transit from the pharynx into the esophagus. This current data enhances our understanding of the biomechanical features contributing to RAD and therefore helps to guide dysphagia management in this patient population.

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Background: The number of patients with dementia is increasing exponentially. Recent studies have already shown that swallowing difficulties (dysphagia) have a significantly higher prevalence in patients with dementia than in individuals without dementia. Dysphagia in patients with dementia is characterised by chewing difficulties, coughing during meals and storing food in the mouth. However, no in-depth study about the prevalence and phenotype of dysphagia in the various subtypes of dementia has yet been performed. This scoping review distinguishes dementia into four main subtypes, namely Alzheimer’s disease, vascular dementia, Lewy body dementia (including Parkinson’s disease dementia) and frontotemporal dementia. Additionally, mixed dementia (with presence of at least two of the previous subtypes) is discussed. This scoping review aims to describe potential differences in the prevalence and expression of dysphagia between the subtypes of dementia, as well as to evaluate the quality of the available body of evidence. It is hypothesised that the signs and symptoms of dysphagia vary among the subtypes of dementia, depending on the affected brain areas. Methods: A systematic search strategy was performed in seven electronic databases to determine relevant studies between 2013 and 2023. These studies were screened based on title and abstract and later based on full text using eligibility criteria. Relevant data was then extracted from the included studies and summarised both schematically and narratively, after which the quality of the relevant findings of the included studies was evaluated. Results: 21 studies were included in this scoping review. The prevalence of dysphagia ranges broadly, between 7 and 83%, and does not vary significantly among the various subtypes of dementia. However, some differences in the expression of dysphagia between the dementia subtypes were found. While all subtypes mainly include oropharyngeal difficulties leading to reduced swallowing efficiency and safety, Alzheimer’s disease is often characterised by delayed swallowing reflex and prolonged duration of the swallowing act. In frontotemporal dementia, on the other hand, dysexecutive and motor problems are often reported, including difficulty with specific types of food and problems with opening the mouth. Furthermore, when comparing Lewy body dementia to Parkinson’s disease dementia, differences in the presentation of dysphagia are found. In Lewy body dementia, the onset of dysphagia is earlier, its progression is faster and the life expectancy after the first dysphagia symptoms is approximately ten years shorter. However, the number and quality of the included studies are too low to draw any conclusions. Furthermore, the definition of dysphagia is heterogeneous among studies and too many different outcome measurements are used to adequately compare results. Conclusion: This scoping review found little evidence that the signs and symptoms of dysphagia vary among the subtypes of dementia, including the nature of these signs and symptoms, expression of the first symptoms, progression and life expectancy after the first symptoms. No final conclusions can be made, due to the small number and relatively low quality of included studies. It is, however, essential to perform individual, instrumental assessments to diagnose dysphagia in the dementia population due to the heterogeneity in dysphagia presentation among the dementia subtypes.

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Background: The number of patients with dementia is increasing exponentially. Recent studies have already shown that swallowing difficulties (dysphagia) have a significantly higher prevalence in patients with dementia than in individuals without dementia. Dysphagia in patients with dementia is characterised by chewing difficulties, coughing during meals and storing food in the mouth. However, no in-depth study about the prevalence and phenotype of dysphagia in the various subtypes of dementia has yet been performed. This scoping review distinguishes dementia into four main subtypes, namely Alzheimer’s disease, vascular dementia, Lewy body dementia (including Parkinson’s disease dementia) and frontotemporal dementia. Additionally, mixed dementia (with presence of at least two of the previous subtypes) is discussed. This scoping review aims to describe potential differences in the prevalence and expression of dysphagia between the subtypes of dementia, as well as to evaluate the quality of the available body of evidence. It is hypothesised that the signs and symptoms of dysphagia vary among the subtypes of dementia, depending on the affected brain areas. Methods: A systematic search strategy was performed in seven electronic databases to determine relevant studies between 2013 and 2023. These studies were screened based on title and abstract and later based on full text using eligibility criteria. Relevant data was then extracted from the included studies and summarised both schematically and narratively, after which the quality of the relevant findings of the included studies was evaluated. Results: 21 studies were included in this scoping review. The prevalence of dysphagia ranges broadly, between 7 and 83%, and does not vary significantly among the various subtypes of dementia. However, some differences in the expression of dysphagia between the dementia subtypes were found. While all subtypes mainly include oropharyngeal difficulties leading to reduced swallowing efficiency and safety, Alzheimer’s disease is often characterised by delayed swallowing reflex and prolonged duration of the swallowing act. In frontotemporal dementia, on the other hand, dysexecutive and motor problems are often reported, including difficulty with specific types of food and problems with opening the mouth. Furthermore, when comparing Lewy body dementia to Parkinson’s disease dementia, differences in the presentation of dysphagia are found. In Lewy body dementia, the onset of dysphagia is earlier, its progression is faster and the life expectancy after the first dysphagia symptoms is approximately ten years shorter. However, the number and quality of the included studies are too low to draw any conclusions. Furthermore, the definition of dysphagia is heterogeneous among studies and too many different outcome measurements are used to adequately compare results. Conclusion: This scoping review found little evidence that the signs and symptoms of dysphagia vary among the subtypes of dementia, including the nature of these signs and symptoms, expression of the first symptoms, progression and life expectancy after the first symptoms. No final conclusions can be made, due to the small number and relatively low quality of included studies. It is, however, essential to perform individual, instrumental assessments to diagnose dysphagia in the dementia population due to the heterogeneity in dysphagia presentation among the dementia subtypes.