Journal of Rehabilitation Medicine 51-4inkOmslag

J Rehabil Med 2019; 51: 312–316 SHORT COMMUNICATION ESTIMATING NUTRITION INTAKE STATUS OF COMMUNITY-DWELLING ELDERLY PEOPLE REQUIRING CARE IN DISASTER SETTINGS: A PRELIMINARY CROSS- SECTIONAL SURVEY Syoichi TASHIRO, MD, PhD 1,2 , Michiyuki KAWAKAMI, MD, PhD 1 , Asako OKA, MD 3,1 , Fumio LIU, MD, PhD 1 , Atsuko NISHIMURA, MD 1 , Chieko OGAWA, NS 4 , Fujio HAGAI, ST 5 , Sirou YAMAMOTO, MD, PhD 6,7 , Masato YAZAWA, DDM, PhD 4 and Meigen LIU, MD, PhD 1 From the 1 Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, 2 Department of Rehabilitation, National Sanatorium Tamazenshoen, Higash-Murayama, 3 Department of Rehabilitation, Saisei-kai Kanagawa Prefecture Hospital, Yokohama, 4 Division of Health Promotion, Department of Health, Shinjuku Local Government, Shinjuku, 5 Department of Rehabilitation, Keio University Hospital, 6 Disaster Management Team, Medical Association of Shinjuku, Shinjuku and 7 Yamamoto Clinic, Akebono-kai, Shinjuku, Tokyo, Japan Objective: There are a lack of disaster preparedness measures that target populations with dysphagia. In particular, disaster response plans frequently over- look differences in textures between emergency foods and regularly consumed foods. The aim of this study was to estimate the number of community- dwelling elderly care recipients requiring specific food preparations, including the population at risk of aspiration when solely consuming common emer- gency foods. Design: A cross-sectional study. Patients: Community-dwelling elderly care reci- pients who were certified by the public long-term care insurance system in Japan and registered at one of 77 care managing offices in Shinjuku city. Methods: Special needs regarding food intake and risks associated with receiving emergency foods were assessed by government-certified care managers. Results: Data were acquired from 1,271 care reci- pients. Notably, 23.1% of the sampled population had special needs regarding food intake at all times (e.g. non-oral intake or need for texture-modified foods). An additional 11.5% were estimated to expe- rience difficulty when ingesting common emergency foods, despite the ability to consume regular foods. Conclusion: A relatively large portion of community- dwelling elderly people will be at risk of aspiration due to the intake of commonly distributed emergen- cy foods following a disaster. Appropriate prepara- tion based on an assessment of special needs regar- ding food intake is therefore required when planning for future disasters. Key words: aspiration; disaster medicine; dysphagia; emer- gency food; long-term care; shelter-acquired pneumonia; preventive medicine; disaster rehabilitation. Accepted Feb 8, 2019; Epub ahead of print Mar 6, 2019 J Rehabil Med 2019; 51: 312–316 Correspondence address: Michiyuki Kawakami, Department of Reha- bilitation Medicine, Keio University School of Medicine, 35 Shinano- machi, Shinjuku city, Tokyo, Japan. E-mail: michiyukikawakami@hot- mail.com D isaster rehabilitation aims to provide optimal care for health problems experienced by the LAY ABSTRACT Emergency foods provided following disasters have con- siderably different textures from regularly consumed foods. This may lead to an increase in the rate of aspira- tion pneumonia in vulnerable populations after a disas- ter. However, no studies have focused on this issue. To better estimate the size of the population with swallo- wing disorders (i.e. dysphagia), a local district-based to- tal population survey of community-dwelling elderly care recipients who were registered in the mandatory long- term care insurance system in Shinjuku city, Tokyo, Ja- pan was performed. Data were collected by government- certified care managers. While 23.1% of the population experienced dysphagia in ordinary settings (i.e. non-oral nutrition intake or daily dependency on texture-modified foods), an additional 11.5% were identified as at-risk solely through a diet consisting of emergency foods. This study indicates the importance of preparedness measu- res that take this latter population into account. affected population, manage various complications, and optimize function, while reducing disabilities in interaction with the environment. The past 20 years have seen a doubling in the number of disasters, which has been attributed to global climate change (1). Thus, this issue has become increasingly important. Preven- tion of aspiration pneumonia is an important goal of disaster rehabilitation (2). Vulnerable populations are presumed to face an increasing risk of aspiration in post-disaster settings, which is particularly related to a reduced ability to ingest emergency foods, such as pre-gelatinized rice and biscuits/crackers/cereals, which are often unfamiliar and not easily swallowed, particularly when provided in non-ordinary settings, such as temporary shelters (3, 4). Recent epidemiological studies have revealed a remarkable increase in the prevalence of pneumonia among people displaced after disasters (5, 6). Specifi- cally, elderly people and those with dysphagia related to neurological disorders are more likely to develop pneumonia beyond the first week after a disaster (7). This complication has been attributed to aspiration of emergency foods and is consequent to shortages in This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm doi: 10.2340/16501977-2542 Journal Compilation © 2019 Foundation of Rehabilitation Information. ISSN 1650-1977

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