Dysphagia diet determination device

Abstract

To provide a dysphagia diet determination device capable of accurately determining the selection of a meal suitable for the individual swallowing state of a subject.SOLUTION: The swallowing food determination device is a swallowing food determination device for determining a swallowing food layer suitable for a subject on the basis of a meal situation of the subject from among swallowing food layers obtained by classifying the swallowing food into a plurality of layers on the basis of a degree of eating and swallowing, the swallowing food determination device including: an apnea measurement means for measuring an apnea situation in which breathing of the subject becomes apnea during a meal on the basis of the meal situation; a reflex measurement means for measuring a reflex situation of a swallowing reflex generated in a larynx of the subject during a meal on the basis of the meal situation; and a determination means for determining the swallowing food layer suitable for the subject on the basis of the apnea situation and the reflex situation.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to the field of dysphagia foods, and more particularly to a dysphagia food determination device that can determine the optimal dysphagia food for each individual. [Background technology]

[0002] The swallowing and chewing actions involved in eating and drinking are complex and multi-tasking movements involving various organs. Dysphagia is known as a disorder that affects these actions.

[0003] Swallowing disorders are a factor that can reduce quality of life (QOL) and can also cause aspiration pneumonia and choking symptoms, so to date, diagnosis of swallowing disorders has been made using various tests.

[0004] For example, a swallowing endoscopy (VE) is an examination in which a nasal fiberscope (endoscope) is inserted into the pharynx to observe the swallowing process as food is swallowed. It can evaluate the presence or absence of saliva or sputum retention, the presence or absence of food remaining in the pharynx after swallowing, and whether food has entered the trachea (aspiration), but because an endoscope is inserted into the pharynx, the examination causes some pain and discomfort to the examinee.

[0005] For example, a videofluoroscopic swallowing test involves swallowing a liquid, thickened liquid, jelly, or a portion of actual food mixed with a contrast agent under X-ray fluoroscopy. Since actual food is consumed during the test, there are associated risks of aspiration, choking, and even radiation exposure.

[0006] In order to improve the techniques for such various examinations, various prior art techniques related to swallowing disorders have been disclosed.

[0007] For example, a conventional technique related to swallowing disorders discloses a swallowing estimation device that includes a sound detection unit that detects sounds from the larynx, a breathing detection unit that detects breathing, and a swallowing estimation unit that estimates swallowing based on sound information output from the sound detection unit and breathing information output from the breathing detection unit, where the swallowing estimation unit acquires parameter values ​​for swallowing estimation for a body sound generation section corresponding to an apnea section of 400 msec or more, and estimates whether swallowing has occurred in the body sound generation section based on whether the acquired parameter values ​​satisfy a swallowing judgment condition (see Patent Document 1).

[0008] Furthermore, for example, a prior art related to swallowing disorders discloses a swallowing activity monitoring device having a first information acquisition unit that acquires first biological information corresponding to the movement of the suprasternal notch of the subject, a second information acquisition unit that acquires second biological information corresponding to the respiratory activity of the subject, and a swallowing activity detection unit that detects a cessation of the subject's respiratory activity based on the second biological information and detects the swallowing activity of the subject based on the first biological information during the detected period of cessation of respiratory activity (see Patent Document 2). [Prior art documents] [Patent documents]

[0009] [Patent Document 1] International Publication No. 2015 / 029501 [Patent Document 2] Japanese Patent Application Laid-Open No. 2011-4968 DISCLOSURE OF THE INVENTION [Problem to be solved by the invention]

[0010] However, in conventional technologies related to swallowing disorders, for example, as disclosed in Patent Documents 1 and 2, there are known swallowing estimation devices that estimate the swallowing status of a subject and swallowing activity monitoring devices that monitor the swallowing status of a subject, but these only serve to confirm the swallowing status of the subject.

[0011] From the perspective of improving the quality of life (QOL) of subjects with dysphagia, it is important to select a diet (dysphagia diet) that suits each subject's swallowing condition, but currently such dietary selection is made by trial and error and in a uniform manner based on empirical intuition. As a result, there are many cases where a diet that does not match the subject's swallowing condition is selected, which tends to reduce the subject's quality of life (QOL) and leads to an unstable situation.

[0012] The present invention has been made to solve the above-mentioned problems, and aims to provide a swallowing food determination device that can accurately determine the selection of food that suits the individual swallowing situation of a subject. [Means for solving the problem]

[0013] The present inventors have conducted extensive research into the mechanisms that cause aspiration, and have discovered a method for accurately determining a subject's swallowing status and optimal diet, leading to the present invention.

[0014] Thus, the present invention is a swallowing food judgment device that judges the swallowing food tier that suits a subject based on the subject's eating situation, from among multiple tiers of swallowing food that are classified into tiers based on the degree of eating and swallowing, and is equipped with an apnea measurement means that measures an apnea state in which the subject's breathing becomes apneic while eating, based on the eating situation, a reflex measurement means that measures a reflex state of the swallowing reflex that occurs in the subject's larynx while eating, based on the eating situation, and a judgment means that judges the swallowing food tier that suits the subject based on the apnea state and the reflex state.

[0015] In this way, the swallowing diet assessment device determines the swallowing diet tier that suits a subject based on the subject's eating situation, out of the multiple tiers of swallowing diets that are classified based on the degree of eating and swallowing, and is equipped with an apnea measurement means that measures the apnea state in which the subject stops breathing while eating, based on the eating situation, a reflex measurement means that measures the reflex state of the swallowing reflex that occurs in the subject's larynx while eating, based on the eating situation, and a judgment means that determines the swallowing diet tier that suits the subject based on the apnea state and the reflex state.Therefore, the swallowing situation of the subject is judged based on the apnea state and the reflex state, which differ for each subject, including the risks and safety that arise from eating (ingestion), and the optimal swallowing diet tier is determined according to the subject's swallowing situation.

[0016] Furthermore, in the present invention, the apnea state includes the occurrence state of the apnea as needed. In this way, since the apnea state includes the occurrence state of the apnea, occurrence states such as whether the apnea occurs early or late, or for a long or short period of time are taken into consideration, and the optimal swallowing diet hierarchy according to the swallowing state of the subject can be determined with higher accuracy.

[0017] Furthermore, in the present invention, the reflex status includes the appearance status of the swallowing reflex as needed. In this way, since the reflex status includes the appearance status of the swallowing reflex, the appearance status of the swallowing reflex, for example, whether the swallowing reflex appears early or late, or for a long or short time, is taken into consideration, and the optimal swallowing food hierarchy according to the swallowing status of the subject can be determined with higher accuracy.

[0018] Furthermore, in the present invention, if necessary, the judgment means judges the swallowing diet hierarchy suitable for the subject based on the time from when the subject starts eating to when the apnea and / or swallowing reflex appears. In this way, the judgment means judges the swallowing diet hierarchy suitable for the subject based on the time from when the subject starts eating to when the apnea and / or swallowing reflex appears, so that the swallowing diet hierarchy is judged according to the characteristics of the swallowing situation, which differ for each subject, and the optimal swallowing diet hierarchy suitable for the swallowing situation of the subject is judged with higher accuracy.

[0019] Furthermore, the present invention may, as necessary, comprise a meal recording means for recording the meal contents of the subject, and an appropriate diet determination means for determining an appropriate diet for the subject based on the meal contents and the dysphagia diet hierarchy determined by the determination means. As such, the present invention comprises a meal recording means for recording the meal contents of the subject, and an appropriate diet determination means for determining an appropriate diet for the subject based on the meal contents and the dysphagia diet hierarchy determined by the determination means. The meal contents of the subject recorded by the meal recording means are taken into consideration, and the subject's eating behavior, such as the type of food eaten, so that the appropriate diet for the subject can be determined more specifically and with higher accuracy by the appropriate diet determination means.

[0020] Furthermore, in the present invention, the dietary content includes, as needed, a dietary image and / or a dietary menu of the subject. In this way, since the dietary content includes a dietary image and / or a dietary menu of the subject, an appropriate diet is determined based on the specific individual dietary content of the subject, and the appropriate diet determination means determines an appropriate diet for the subject more specifically and with high accuracy.

[0021] Furthermore, in the present invention, if necessary, the determination means determines the degree of ease of eating of food for the subject based on the apnea state and the reflex state, and determines the swallowing food hierarchy suitable for the subject based on the degree of ease of eating. In this way, the determination means determines the degree of ease of eating of food for the subject based on the apnea state and the reflex state, and determines the swallowing food hierarchy suitable for the subject based on the degree of ease of eating, so that the swallowing food hierarchy is determined according to the degree of ease of eating of food, which differs for each subject, and the optimal swallowing food hierarchy is determined with greater accuracy according to the swallowing state of the subject.

[0022] Furthermore, the present invention further comprises a notification means for notifying the swallowing food hierarchy determined by the determination means, as necessary. In this way, by providing a notification means for notifying the swallowing food hierarchy determined by the determination means, the optimal swallowing food hierarchy for the subject can be quickly shared with relevant parties, and flexible changes to the swallowing food provided to the subject can be quickly made. [Brief explanation of the drawings]

[0023] [Figure 1] 1 shows a configuration diagram of a swallowed meal determination device according to a first embodiment of the present invention. [Figure 2] FIG. 1 shows an explanatory diagram illustrating the swallowed food hierarchy of the swallowed food determination apparatus according to the first embodiment of the present invention. [Figure 3] FIG. 2 shows an explanatory diagram illustrating a swallowing reflex state and an apnea state of the swallowed meal determining apparatus according to the first embodiment of the present invention. [Figure 4] FIG. 2 shows an explanatory diagram illustrating a swallowing reflex state and an apnea state of the swallowed meal determining apparatus according to the first embodiment of the present invention. [Figure 5] FIG. 2 shows an explanatory diagram illustrating a swallowing reflex state and an apnea state of the swallowed meal determining apparatus according to the first embodiment of the present invention. [Figure 6] FIG. 2 shows an explanatory diagram of four waveforms detected by a sensor regarding a swallowing reflex state and an apnea state of the swallowed meal determining device according to the first embodiment of the present invention. [Figure 7] 1 shows a configuration diagram of a swallowed meal determination device according to a first embodiment of the present invention. [Figure 8] FIG. 10 shows a configuration diagram of a swallowed meal determining device according to a second embodiment of the present invention. [Figure 9] 1 shows the results of dysphagia food assessment according to Example 1 of the present invention. [Figure 10] 10 shows the results of dysphagia food assessment according to Example 2 of the present invention. [Figure 11] 10 shows the results of dysphagia food assessment according to Example 3 of the present invention. DETAILED DESCRIPTION OF THE INVENTION

[0024] (First embodiment) As shown in FIG. 1, the swallowing food assessment device according to the first embodiment is a swallowing food assessment device that determines a swallowing food hierarchical level that suits a subject 100 based on the subject's eating situation, out of multiple hierarchical levels of swallowing food that are classified based on the degree of eating and swallowing. The device is configured to include: a receiving means 1 that receives the eating situation; an apnea measuring means 2 that measures an apnea state in which the subject 100 stops breathing while eating, based on the received eating situation; a reflex measuring means 3 that measures a reflex state of the swallowing reflex that occurs in the larynx of the subject 100 while eating, based on the eating situation; and a determining means 4 that determines the swallowing food hierarchical level that suits the subject 100, based on the apnea state and the reflex state.

[0025] The subject 100 is also fitted with a breathing sensor 11 that detects the apnea state of the subject 100 and a larynx sensor 12 that detects the reflex state of the swallowing reflex at the larynx of the subject 100. The receiving means 1 receives the eating state detected by the breathing sensor 11 and the larynx sensor 12.

[0026] This respiration sensor 11 can use conventional technology, and for example, as described in a conventional document (JP 2011-212231 A), it is possible to detect the apnea period from the temperature difference between the exhaled and inhaled air passing through the nasal cavity.

[0027] This laryngeal sensor 12 can use conventional technology, and for example, as described in a conventional document (JP 2011-212231 A), can be configured to include a laryngeal sensor attached to the front of the subject's neck, and a swallowing reflex sensor that measures the reflex status of the swallowing reflex after food is inserted into the oral cavity based on magnetic field changes detected by a handheld tool such as chopsticks, a spoon, or a fork equipped with a magnetic field change detection unit that detects magnetic field changes.

[0028] The dysphagia food hierarchy is a classification of dysphagia foods into multiple hierarchical levels based on the degree of eating and swallowing. For example, as shown in Figure 2, this corresponds to the 5- or 6-level dysphagia food hierarchy (dysphagia food pyramid) proposed by the Japanese Society of Eating and Swallowing Rehabilitation.

[0029] For example, in the six-level dysphagia food hierarchy (dysphagia food pyramid), various types of food are classified into six levels in order of increasing difficulty of eating and swallowing: normal food (level 5), nursing care food (level 4), dysphagia food (level 3), dysphagia training food (level 2), dysphagia training food (level 1), and dysphagia training food (level 0), and the physical properties of the food form for each level are standardized.

[0030] The apnea measuring means 2 receives the eating condition detected by the breathing sensor 11. Based on the eating condition, an apnea condition in which the subject 100 stops breathing while eating is measured.

[0031] Preferably, the apnea state includes an occurrence state of apnea, such as an early or late occurrence of apnea in the subject 100.

[0032] Furthermore, for example, if apnea occurs early, it is determined that the patient is aware of the swallowing action earlier than the actual timing of eating and drinking, and since there is a risk that the food will get stuck in the pharynx if the patient actually eats and drinks at that timing, the judgment means 4 can determine that a food with a lower viscosity and particle size is more optimal.

[0033] Furthermore, for example, if apnea occurs late, it is determined that the patient is not consciously swallowing at the correct timing, and since there is a risk that a meal with high viscosity and particle size will get stuck in the pharynx, the judgment means 4 can determine that a meal with low viscosity and particle size is more optimal.

[0034] Furthermore, for example, if apnea continues for a long period of time, it is determined that the actual food is difficult to swallow, and if the viscosity and particle size of the food are not low, it will cause blockage in the pharynx, so the above-mentioned judgment means 4 can determine that a food with a low viscosity and particle size is more optimal.

[0035] Furthermore, for example, when apnea occurs for a short period of time, food cannot be retained in the oral cavity or pharynx for a certain period of time, and in this case, if the food does not have a high viscosity and particle size, it will cause blockage of the pharynx, so the judgment means 4 can determine that a food with a high viscosity and particle size is more optimal.

[0036] The reflex measuring means 3 measures the reflex state of the swallowing reflex occurring in the larynx of the subject 100 while eating, based on the eating state detected by the larynx sensor 12.

[0037] In this case, when food is inserted into the subject's mouth, the device approaches the subject's lips, causing a magnetic field change to be detected by the magnetic field change detection unit, and based on this magnetic field change, the swallowing reflex sensor measures the reflex status of the swallowing reflex.

[0038] In addition, this reflex measuring means 3 can measure the swallowing reflex from the shape change near the larynx when food is inserted into the subject's oral cavity by attaching a shape change detection sensor that detects changes in the shape of the larynx near the subject's larynx.

[0039] The object of detection by this sensor is not particularly limited, but it is possible to measure, for example, based on the movement waveform of bones and / or cartilages related to the subject's pharynx. For example, the swallowing reflex can be measured from the movement waveform of the hyoid bone and / or thyroid cartilage.

[0040] Preferably, the reflex status includes the occurrence status of the swallowing reflex, for example, whether the swallowing reflex of the subject occurs early or late.

[0041] For example, if the swallowing reflex occurs early, it is determined that the patient is conscious of the act of swallowing earlier than the actual food, and there is a risk that the food will get stuck in the pharynx when actually swallowed, so the above-mentioned judgment means 4 can determine that a meal with a low viscosity and particle size is more optimal.

[0042] Furthermore, for example, if the swallowing reflex occurs at a late stage, it is determined that the awareness of the swallowing action is slower than the actual food, and since there is a risk that the food will get stuck in the pharynx if the food has high viscosity and particle size, the above-mentioned judgment means 4 can determine that a food with low viscosity and particle size is more optimal.

[0043] Furthermore, for example, if the swallowing reflex continues for a long period of time (for example, when the food in the mouth is processed by performing multiple swallowing reflexes while continuing to hold an apnea after ingesting a single bite), it is determined that the actual food is difficult to swallow, and if the viscosity and particle size of the food are high, there is a risk that it will get stuck in the pharynx.Therefore, the above-mentioned judgment means 4 can determine that a food with a low viscosity and particle size is more optimal.

[0044] Furthermore, for example, if the swallowing reflex occurs for a short time (for example, if the swallowing reflex occurs for a short time and has a small amplitude), it is determined that there is a problem with the occurrence of the swallowing reflex itself, and since foods with low viscosity or particle size pose a risk of getting stuck in the pharynx or being aspirated into the trachea, the above-mentioned judgment means 4 can determine that a meal with a high viscosity and particle size is more optimal. Note that the swallowing reflex can be judged from the presence or absence of occurrence and the up and down amplitude of the movement waveform of the hyoid bone and / or thyroid cartilage (normally about 1.5 cm).

[0045] Furthermore, the determining means 4 determines the swallowing state based on the apnea state and the reflex state, and determines the swallowing level.

[0046] The swallowing status can be determined, for example, from the degree of coordination between swallowing apnea and the swallowing reflex. The degree of coordination indicates a state in which the proportion of the time period in which swallowing apnea and the swallowing reflex overlap is high (e.g., 80% or more). For example, as shown in FIG. 3, if the proportion of the time period in which swallowing apnea and the swallowing reflex overlap is high, the degree of coordination can be determined to be high. Also, for example, as shown in FIG. 4, if the proportion of the time period in which swallowing apnea and the swallowing reflex overlap is low (e.g., less than 10%), the degree of coordination can be determined to be low.

[0047] The lower the degree of coordination between swallowing apnea and swallowing reflex, the more likely the swallowing situation is to be aspiration, and the judgment means 4 judges, based on the degree of coordination, that a swallowing food hierarchy with lower viscosity and particle size is preferable as the optimal swallowing food hierarchy.Furthermore, the higher the degree of coordination between swallowing apnea and swallowing reflex, the more likely the swallowing situation is healthy, and the judgment means 4 judges, based on the degree of coordination, that a swallowing food hierarchy with higher viscosity and particle size is preferable as the optimal swallowing food hierarchy.

[0048] For example, when the degree of coordination between swallowing apnea and swallowing reflex is 100% (when they occur at the same time), this judgment means 4 judges that the normal food (level 5) swallowing food hierarchy is the optimal hierarchy out of the six levels of the swallowing food hierarchy (swallowing food pyramid) mentioned above.

[0049] Furthermore, for example, if the degree of coordination between swallowing apnea and swallowing reflex is 75%, the nursing care food (level 4) swallowing food hierarchy is judged to be the optimal hierarchy out of the six levels of the swallowing food hierarchy (swallowing food pyramid) mentioned above.

[0050] Furthermore, when the degree of coordination between swallowing apnea and swallowing reflex is 50%, the swallowing food hierarchy (level 3) or swallowing training food (level 2) is judged to be the optimal hierarchy of the six-level swallowing food hierarchy (swallowing food pyramid) described above.

[0051] Furthermore, when the degree of coordination between swallowing apnea and swallowing reflex is 25%, the swallowing training diet (level 2) is judged to be the optimal level among the six levels of the swallowing diet hierarchy (swallowing diet pyramid) described above.

[0052] Furthermore, when the degree of coordination between swallowing apnea and swallowing reflex is 0%, the swallowing training diet (level 0) is judged to be the optimal level among the six levels of the swallowing diet hierarchy (swallowing diet pyramid) described above.

[0053] In addition, the swallowing status can be determined based on, for example, which of the apnea state and the reflex state occurs first. For example, if the apnea state occurs before the reflex state, it is determined that the apnea state occurs before the swallowing action, and therefore the swallowing action is being carefully selected. Therefore, for safety reasons, it is possible to slightly underestimate the actual swallowing action among the above six levels of the swallowing food hierarchy (the swallowing food pyramid), and to correct the swallowing food hierarchy determined to be the optimal level to a lower level.

[0054] Conversely, if this reflex state occurs before the apnea state, it is determined that the swallowing action is being rushed, since the apnea state occurs before the swallowing action. Therefore, of the above six levels of the swallowing food hierarchy (the swallowing food pyramid), it is possible to correct the swallowing food hierarchy to one that has a viscosity and particle size that makes the swallowing action easier, which is determined to be the optimal level.

[0055] In this way, the swallowing condition of each subject 100 is judged based on the apnea condition and reflex condition, which differ for each subject 100, and the optimal swallowing food hierarchy according to the swallowing condition of each subject 100 is determined.

[0056] In addition, it is preferable that the judgment means 4 judges the swallowing diet hierarchy that is suitable for the subject 100 based on the time from when the subject 100 starts eating to when the apnea and / or swallowing reflex appears.

[0057] To detect this emergence time, for example, the sensor described in the above-mentioned prior art document (JP 2011-212231 A) can be used. This reflex measuring means 3 includes a laryngeal sensor attached to the front of the neck of the subject, a handheld implement such as chopsticks, a spoon, or a fork equipped with a magnetic field change detector that detects magnetic field changes, and a swallowing reflex sensor that measures the reflex status of the swallowing reflex based on the detected magnetic field changes, so that it is possible to detect that food has been inserted into the oral cavity of the subject and to detect the emergence time from the start of eating.

[0058] In addition, whether the time from the start of the meal to the appearance of the swallowing reflex or apnea is early or late can be determined using the normal value of 0.5 to 0.6 seconds, which is the time from when something enters the oral cavity to when the swallowing reflex appears (laryngeal movement latency), as a threshold value.

[0059] Alternatively, for example, the number of peaks and troughs of the respiratory wave can be used as a threshold for judgment. For example, as shown in Fig. 5, since the peak (inhalation period) of the respiratory wave is usually 1 second, the trough (exhalation period) of the respiratory wave is 1.5 seconds, and the resting period is 1 second, and the duration of one respiratory wave (breathing time) is 3.5 to 5 seconds, using the fact that the number of peaks (inhalation period) and troughs (exhalation period) of the respiratory wave is 3, for example, as a threshold, it can be used to judge whether the time from the start of the meal to the appearance of the swallowing reflex or apnea is early or late.

[0060] Furthermore, as shown in Figure 6, images of the four waveforms obtained using the above sensor (the top one is the waveform j when the spoon is placed in the mouth, the second from the top is the hyoid bone movement waveform k, the third from the top is the thyroid cartilage movement waveform l, and the fourth from the top is the respiratory movement waveform m) can be displayed as a video in real time on the display screen of a PC terminal, and these images can be saved as needed to confirm the times at which the above waveforms appear. The second from the top, the hyoid bone movement waveform k, and the third from the top, the thyroid cartilage movement waveform l, usually coincide in their large amplitude regions, indicating that the swallowing reflex and laryngeal movement qualitatively coincide in waveform.

[0061] In addition, by displaying the PC terminal as a still image and dividing the waveform for which you want to measure the time with a vertical line, you can confirm the above appearance times.

[0062] This allows the swallowing food hierarchy to be determined according to the characteristics of the swallowing situation, which differ for each subject 100, and the optimal swallowing food hierarchy according to the swallowing situation of the subject 100 can be determined with higher accuracy.

[0063] Also, for example, as shown in FIG. 7, a notification means 5 for notifying the swallowing food hierarchy determined by the determination means 4 may be provided.

[0064] The notification means 5 is not particularly limited, but examples thereof include screen output, audio output, and a nurse call in a medical setting. As a screen output, the optimal dysphagia food hierarchy can be notified in real time on a computer screen. For example, by notifying the dysphagia food hierarchy determined to be optimal via a nurse call, medical personnel can immediately confirm that the dysphagia food currently being eaten poses a risk, and can interrupt the dysphagia food currently being eaten and quickly change to a lower-risk diet.

[0065] In this way, since the system is provided with a notification means 5 that notifies the swallowing food hierarchy determined by the determination means 4, the optimal swallowing food hierarchy for the subject 100 can be quickly shared with relevant parties, and flexible changes can be made quickly to the swallowing food provided to the subject 100.

[0066] (Second embodiment) As shown in FIG. 8, the swallowing food assessment device according to the second embodiment comprises the reception means 1, the apnea measurement means 2, the reflex measurement means 3, and the assessment means 4, similar to the first embodiment, and further comprises a meal recording means 6 that records the meal contents of the subject 100, and an appropriate meal assessment means 7 that assesses a meal suitable for the subject 100 based on the meal contents and the swallowing food hierarchy assessed by the assessment means 4.

[0067] The meal recording means 6 records the meal contents of the subject 100. The meal contents preferably include images of the meal the subject 100 eats and / or a meal menu.

[0068] The meal image is an image of the subject 100 while eating, and includes, for example, images relating to eating behaviors such as the type of food captured through handheld utensils, the action of bringing food to the mouth, the state of chewing, and the state of spilling food. This image can be detected by detecting the contour (edge) of the subject 100. For example, if the shape around the mouth of the subject 100 continues to expand by, for example, 5% or more based on changes in the contour (edge) of the subject 100 over time, it can be detected that the subject is chewing food. Furthermore, for example, if there is any substance falling from the vicinity of the mouth of the subject 100, it can be detected that the subject is spilling food.

[0069] This meal menu is the contents of the food eaten by this subject 100, and includes, for example, all swallowing-adjusted foods and meal menus such as three daily meals.

[0070] The appropriate diet determination means 7 determines a diet suitable for the subject 100 based on the dietary content and the dysphagia diet hierarchy determined by the determination means 4 .

[0071] For example, if the degree of coordination between swallowing apnea and swallowing reflex is 100%, and if the normal food (level 5) of the six-level swallowing food hierarchy (swallowing food pyramid) is determined to be the optimal hierarchy, and if the meal menu of the subject 100's meal is curry, and the subject's mouth is expanded by 10% or more in the meal image compared to the pre-meal state, then a vegetable mousse with a lower viscosity than curry, based on a nutritional amount of 500 ml and 300 kcal per meal, is determined to be the appropriate meal for the subject 100. Note that mousse has a texture that sticks to the inside of the subject's mouth and is considered a more advanced food than jelly, and therefore is determined to be more suitable than jelly in this case.

[0072] Furthermore, for example, if the degree of coordination between swallowing apnea and swallowing reflex is 50%, and if the swallowing food hierarchy (level 3) or swallowing training food (level 2) of the six-level swallowing food hierarchy (swallowing food pyramid) described above is determined to be the optimal hierarchy, and if the meal menu for subject 100 is mizu yokan and the subject's mouth is 10% or more larger in the meal image compared to the pre-meal state, then fruit juice jelly, which has a lower viscosity than mizu yokan, is determined to be the appropriate meal for subject 100, based on a nutritional amount of 500 ml and 300 kcal per meal.

[0073] This allows the appropriate diet to be determined based on the specific individual dietary content of the subject 100, and the appropriate diet for the subject 100 can be determined more specifically and with higher accuracy by the appropriate diet determination means 7.

[0074] In this way, the system is equipped with a meal recording means 6 that records the dietary contents of the subject 100, and an appropriate diet determination means 7 that determines the diet that is suitable for the subject 100 based on the dietary contents and the swallowing diet hierarchy determined by the determination means 4.From the dietary contents of the subject 100 recorded by the meal recording means 6, the eating behavior of the subject 100, such as the type of food eaten, is also taken into consideration, and the appropriate diet determination means 7 can more specifically and accurately determine the appropriate diet for the subject 100.

[0075] It is also preferable that the judgment means 4 judges the ease of eating food for the subject 100 based on the apnea state and the reflex state, and determines the swallowing food hierarchy that is suitable for the subject 100 based on the ease of eating. This allows the swallowing food hierarchy to be determined according to the degree of ease of eating of food, which differs for each subject 100, and the optimal swallowing food hierarchy can be determined with greater accuracy according to the swallowing situation of the subject 100.

[0076] This allows the swallowing food hierarchy to be determined according to the degree of ease of eating of food, which differs for each subject 100, and the optimal swallowing food hierarchy can be determined with greater accuracy according to the swallowing situation of the subject 100.

[0077] In this embodiment, similarly to the first embodiment, a notification means 5 for notifying the dysphagia food hierarchy determined by the determination means 4 can also be provided.

[0078] Examples will be described below as examples for explaining the present invention, but the present invention is not limited to these examples.

[0079] Example 1 As described in a conventional document (JP 2011-212231 A), the waveforms of laryngeal movement and respiratory movement of a 74-year-old male were detected using a laryngeal sensor 12 including a laryngeal sensor attached to the front of the neck of the subject, a spoon equipped with a magnetic field change detection unit for detecting magnetic field changes, and a swallowing reflex sensor for measuring the swallowing reflex status based on the detected magnetic field changes, and the respiratory sensor 11. The obtained results are shown in Figure 9.

[0080] From the results in Figure 9, for laryngeal movement corresponding to the swallowing reflex, laryngeal movement time bc was detected from trigger a, which is the start of measurement, through laryngeal (swallowing) movement latency ab. For respiratory movement, apnea latency ad, during which respiratory movement is repeated, was detected, followed by apnea time de.

[0081] In determining whether swallowing was necessary, it was determined that coordination was achieved because laryngeal (swallowing) movements and respiratory movements occurred at almost the same time; however, the latency of laryngeal (swallowing) movements from trigger a to ab took place after four respiratory movements, and because these respiratory movements were more than three, it was determined that the time was long, there was no resting period, the expiratory period was short, and there was incomplete apnea; therefore, it was determined that swallowing should begin with swallowing-adjusted food code 0j (swallowing training food 0j).

[0082] Example 2 The swallowing reflex and apnea waveforms of a male Parkinson's patient were detected using the same laryngeal sensor 12 and respiratory sensor 11 as in Example 1. The obtained results are shown in FIG.

[0083] As can be seen from the results in Figure 10, there was no overlap between the timing of the swallowing reflex and the onset of apnea, resulting in an uncoordinated waveform with a large discrepancy between the timing of the swallowing reflex and the onset of apnea. Based on the degree of uncoordinatedness, it was determined that there is currently no appropriate dysphagia-adjusted diet for the optimal dysphagia diet hierarchy, and that functional training should be focused on achieving a coordinated waveform between swallowing and apnea using saliva.

[0084] Example 3 The swallowing reflex and apnea waveforms of a male dementia patient were detected using the same laryngeal sensor 12 and respiratory sensor 11 as in Example 1. The obtained results are shown in FIG.

[0085] The results in Figure 11 show that the timing of the swallowing reflex and apnea onset showed coordinated waveforms. Considering the degree of coordination and the fact that the swallowing reflex appeared and the apnea period continued for a long period, it was determined that the appropriate swallowing diet would be a swallowing training food (code 0t or code 1j) that is homogeneous, low-adhesion, and highly cohesive, among swallowing-adjusted diets. [Explanation of symbols]

[0086] 1. Reception method 11 Respiration sensor 12 Laryngeal Sensor 2 Apnea measurement means 3 Reflection measurement means 4 Judgment means 5. Notification methods 6. Food Recording Methods 7. Appropriate dietary assessment method 100 subjects

Claims

1. A swallowing food assessment device that determines the swallowing food hierarchy that is suitable for a subject based on the subject's eating situation, from among multiple swallowing food hierarchy levels that classify swallowing foods based on the degree of eating and swallowing, an apnea measuring means for measuring an apnea state in which the subject stops breathing while eating based on the eating state; a reflex measuring means for measuring a reflex state of a swallowing reflex occurring in the larynx of the subject while eating based on the eating state; A determination means for determining the dysphagia dietary hierarchy suitable for the subject based on the apnea state and the reflex state; characterized by comprising Dysphagia assessment device.

2. The swallowed food determination device according to claim 1, The apnea situation includes an occurrence situation of the apnea. Dysphagia assessment device.

3. The swallowed food determination device according to claim 1, The reflex status includes the occurrence status of the swallowing reflex. Dysphagia assessment device.

4. The swallowed food determination device according to claim 1, The determining means determines the dysphagia diet hierarchy suitable for the subject based on the time from when the subject starts eating to when the apnea and / or the swallowing reflex appears. Dysphagia assessment device.

5. The swallowed food determination device according to claim 1, a meal recording means for recording the meal contents of the subject; an appropriate diet determination means for determining a diet suitable for the subject based on the dietary content and the dysphagia diet hierarchy determined by the determination means; characterized by comprising Dysphagia assessment device.

6. The swallowed food determination device according to claim 5, The meal content includes a meal image and / or a meal menu of the subject. Dysphagia assessment device.

7. The swallowed food determination device according to claim 1, The determining means determines the degree of ease of eating food for the subject based on the apnea state and the reflex state, and determines the dysphagia food hierarchy suitable for the subject based on the degree of ease of eating. Dysphagia assessment device.

8. The swallowed food determination device according to claim 1, a notification means for notifying the swallowing food hierarchy determined by the determination means; characterized by comprising Dysphagia assessment device.

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