Changes in etiology and severity of dysphagia with aging

Ahn, Da Hyun; Yang, Hea Eun; Kang, Hyo Jung; Hee, Kyung; Han, Seok Cheol; Jang, Soo Woong; Lee, Jang Ho

doi:10.1007/s41999-019-00259-0

Cited by 10 publications

(6 citation statements)

References 36 publications

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“…3,7 Very old age (over 80 years) has been associated with more severe OD and different etiologies than younger adults. 23 Therefore, the aim of this study was to measure the prevalence of OD in the oldest old patients admitted to an acute geriatric unit using an objective, well validated instrument (V-VST). We also wanted to analyze the main risk factors associated with OD and describe the characteristics of hospitalization (length of stay and in-hospital mortality) and discharge (number of drugs and destination at discharge) in hospitalized older patients with OD.…”

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confidence: 99%

High Prevalence of Oropharyngeal Dysphagia in Acutely Hospitalized Patients Aged 80 Years and Older

Mateos‐Nozal

Montero‐Errasquín

García

et al. 2020

Journal of the American Medical Directors Association

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Objectives: Oropharyngeal dysphagia is a geriatric syndrome that is usually underdiagnosed in older patients. The aim of this study was to determine the prevalence and identify the main risk factors of dysphagia in the oldest old patients admitted to an acute geriatric unit. Design: Observational prospective study. Setting and Participants: Older patients admitted to an acute geriatric unit of a university hospital. Measures: 329 patients (mean age 93.5 years, range 81-106) were assessed for oropharyngeal dysphagia within 48 hours of hospital admission using the Volume-Viscosity Swallow Test. Demographic characteristics, geriatric assessment, geriatric syndromes, comorbidities, drug treatment, and complications were examined to determine their association with the presence of dysphagia. Results: Oropharyngeal dysphagia was present in 271 (82.4%) of the participants. Multivariate logistic regression showed that malnutrition [odds ratio (OR) 3.62, 95% confidence interval (CI) 1.01-12.93; P ¼ .048], admission for respiratory infection (OR 2.89, 95% CI 1.40-5.94; P ¼ .004), delirium (OR 2.89, 95% CI 1.40-5.94; P ¼ .004), severe dependency (OR 3.23, 95% CI 1.23-8.87; P ¼ .017), and age (OR 1.11, 95% CI 1.01-1.21; P ¼ .03) were significantly associated with dysphagia. The use of a calcium antagonist at the time of admission was associated with a reduced risk of dysphagia (OR 0.39, 95% CI 0.16-0.92; P ¼ .03). Conclusions and Implications: The prevalence of oropharyngeal dysphagia is high in the oldest old patients admitted to an acute geriatric unit when assessed with an objective diagnostic method. Our findings suggest that objective swallowing assessment should be routinely performed on admission in order to start early interventions to avoid complications of dysphagia in this complex population.

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confidence: 99%

High Prevalence of Oropharyngeal Dysphagia in Acutely Hospitalized Patients Aged 80 Years and Older

Mateos‐Nozal

Montero‐Errasquín

García

et al. 2020

Journal of the American Medical Directors Association

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“…Furthermore, Ahn et al. (2020) also found that older age was related to severe swallowing disorders. These may be plausible explanations for older age as a negative factor for prognosis of PSD.…”

Section: Discussionmentioning

confidence: 97%

Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta‐analysis

et al. 2023

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Background Poststroke dysphagia (PSD) recovery depends on various factors. We aimed to provide evidence concerning predictive variables for the recovery of PSD. Methods PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP database of Chinese periodicals, Chinese biomedical literature service system (SinoMed), and Cochrane Library databases were systematically searched up to September 21, 2022. According to the inclusion criteria, the literature searched in the database was screened. The methodological quality of included studies was assessed using the Newcastle‐Ottawa Scale (NOS). Meta‐analysis was performed to identify the factors prognostic for PSD. Results Twenty‐eight studies were eligible, and pooled analyses were allowed for 12 potential prognostic factors. We identified older age, higher National Institutes of Health Stroke Scale (NIHSS) score, lower activities of daily living (ADL) score, lower body mass index (BMI), severe dysphagia on admission, aspiration, brainstem stroke, severe cognitive impairment, and bilateral hemispheric stroke were negative factors for the recovery of PSD, while early intervention and Modified Rankin Scale (mRS) = 0 before onset were protective factors for the recovery of PSD. There was no significant association between stroke type and prognosis of PSD. Conclusion Prognostic factors of PSD summarized in this meta‐analysis could be useful for developing reasonable treatment plan to better promote recovery of swallowing function after stroke.

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“…Thus, loss of independence in feeding represents a more advanced state of bADL functional dependency which would portend poorer outcomes. A study of 418 older adults who underwent videofluoroscopic swallow for dysphagia reported that malnutrition and frailty were positively correlated with severe dysphagia, Table 4 Comparison between CFS, mCFS-1, and mCFS-2 against incident mortality and institutionalisation * p < 0.05, † p < 0.001 (Fisher Exact test) a Participants who died during the specified period were counted as a case irrespective of age [23]. Additionally, dependency in feeding has been shown to be a powerful predictor of poorer outcomes including mortality [24].…”

Section: Discussionmentioning

confidence: 99%

Heterogeneity in functional status among moderately frail older adults: improving predictive performance using a modified approach of subgrouping the Clinical Frailty Scale

et al. 2020

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Key summary points Aims To establish if dependency in basic activities of daily living (bADL) amongst moderately frail older adults predict poorer health outcomes including mortality and institutionalisation. We also examined the utility of subgrouping category 6 of the Clinical Frailty Scale (CFS) by level of functional dependency to improve predictive performance. Findings We observed a wider range in functional dependency among CFS 6 patients when compared to other frail categories. Incorporating CFS 6 subcategories based on bADL functional status increased predictive performance for longitudinal adverse outcomes compared with the original CFS scoring. Message This study corroborates the heterogeneity of bADL functional status in CFS 6 individuals and validates the use of a modified approach to subgrouping the CFS via bADL dependency for improved predictive performance. Electronic supplementary material The online version of this article (10.1007/s41999-020-00418-8) contains supplementary material, which is available to authorized users.

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Changes in etiology and severity of dysphagia with aging

Cited by 10 publications

References 36 publications

High Prevalence of Oropharyngeal Dysphagia in Acutely Hospitalized Patients Aged 80 Years and Older

High Prevalence of Oropharyngeal Dysphagia in Acutely Hospitalized Patients Aged 80 Years and Older

Demographic and clinical factors associated with recovery of poststroke dysphagia: A meta‐analysis

Heterogeneity in functional status among moderately frail older adults: improving predictive performance using a modified approach of subgrouping the Clinical Frailty Scale

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