How Swallow Pressures and Dysphagia Affect Malnutrition and Mealtime Outcomes in Long-Term Care

Namasivayam-MacDonald, Ashwini; Morrison, Jill; Steele, Catriona M.; Keller, Heather

doi:10.1007/s00455-017-9825-z

Cited by 74 publications

(48 citation statements)

References 34 publications

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“…The co‐occurrence of a risk of malnutrition and dysphagia is a serious health condition and should not be underestimated. The co‐occurrence of malnutrition and dysphagia generally varies from 3% to 29% (Namasivayam, ; Namasivayam‐MacDonald et al, ). Our results show that the malnutrition risk and dysphagia occurred simultaneously in 2.6% of the whole research sample and that about 40% of patients with dysphagia were at risk of malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Dysphagia and factors associated with malnutrition risk: A 5‐year multicentre study

Blanař

Hoedl

Lohrmann

et al. 2019

Journal of Advanced Nursing

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Aims To describe the associations between dysphagia and malnutrition risk and to identify predictors for dysphagia in a group of persons at risk of malnutrition in hospitals and nursing homes. Design A secondary analysis of cross‐sectional data from the years 2012–2016. Methods The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool for Adults (MUST). The data were compared regarding malnutrition risk and dysphagia. Regression analyses were conducted to identify variables that were associated with the risk of malnutrition and dysphagia. Results Patients (N = 17,580) were included in the study sample. The prevalence of dysphagia was 6.6% and the prevalence of malnutrition risk was 18.9%. A multivariable logistic regression analysis resulted in the identification of dysphagia and cancer as variables with the highest odds ratios with regard to malnutrition risk. Patients with cancer, stroke or respiratory diseases represent a high‐risk group for the co‐occurrence of dysphagia and risk of malnutrition. Conclusions Screening for dysphagia should be carried out on patients at risk of malnutrition as an integral part of their admission to a healthcare institution and especially on the higher risk group of patients with cancer, a stroke or a respiratory disease. Impact What problem did the study address? This study identified the relationship between dysphagia and malnutrition risk and associated factors. What were the main findings? Dysphagia among patients in the research sample was associated with more than two times higher prevalence of the malnutrition risk. Where and on whom will the research have an impact? Thorough malnutrition risk and dysphagia screening lead to better nursing care.

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Section: Discussionmentioning

confidence: 99%

Dysphagia and factors associated with malnutrition risk: A 5‐year multicentre study

Blanař

Hoedl

Lohrmann

et al. 2019

Journal of Advanced Nursing

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“…Older adults are more susceptible to developing dysphagia (swallowing difficulties) [1,2], which is a contributor to the high physical, psychosocial, and financial costs associated with disease [3]. Dysphagia can result in decreased eating, leading to malnutrition and increased pulmonary compromise and mortality [4,5,6,7]. It can also result in decreased social participation, and increased anxiety and depression, which have been linked to decreased quality of life and increased mortality [8,9,10].…”

Section: Introductionmentioning

confidence: 99%

The Burden of Dysphagia on Family Caregivers of the Elderly: A Systematic Review

Namasivayam-MacDonald

Shune

2018

Geriatrics

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With the rapid increase in the elderly population, there is a simultaneous increased need for care provided by family caregivers. Research in the field of head and neck cancer has indicated that caring for patients with dysphagia can impact a caregiver’s quality of life. Given that many older adults present with dysphagia, one can assume that their caregivers are equally, if not more greatly, affected. The purpose of this systematic review was to examine all relevant literature regarding the caregiver burden in caregivers of community-dwelling older adults with dysphagia. A review of relevant studies published through April 2018 was conducted using search terms related to dysphagia, caregiver burden, and older adults. The search yielded 2331 unique abstracts. Of the 176 abstracts that underwent full review, four were accepted. All reported an increase in caregiver burden due to presence of dysphagia in care recipients. Worsening feeding-related behaviors were associated with burden, and the use of feeding tubes was more frequently associated with “heavy burden”. The presence of dysphagia in community-dwelling older adults is a factor leading to an increased burden among caregivers. Although aspects of dysphagia play a role in the caregiver burden, the specific reasons for the increased burden are unknown. Clinicians should be aware of dysphagia as a source of the burden, and future studies should further define the relationship between dysphagia and the caregiver burden in order to develop comprehensive approaches to care.

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“…As MTP reduces and tongue‐to‐palate pressure required for swallowing remains constant, a reduction of the functional reserve may potentially result in a disruption to the swallowing process. In other populations, reduced MTP has been reported to be associated with the presence of OD 16,17,33‐36 . In the sample of patients recruited in the study, MTP was on average 29.7 ± 14 kPa.…”

Section: Discussionmentioning

confidence: 83%

“…In ALS, MTP is recognized to be a marker of disease progression 19 and of bulbar involvement, 20 as well as a poor prognostic factor for survival 18 . In other populations, MTP was reported to be associated with OD, mealtime performance, and malnutrition 16 . The measurement of MTP is associated with the concept of functional reserve.…”

Section: Discussionmentioning

confidence: 99%

“…In the pharyngeal phase, the tongue generates a driving force for bolus propulsion through the pharynx and into the upper esophageal sphincter (UES) 14 . In the elderly and in patients with Parkinson's disease, reduced tongue pressure has been reported to be associated with OD, aspiration, and a lower amount of food and drink intake 15‐17 …”

Section: Introductionmentioning

confidence: 99%

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Association between maximum tongue pressure and swallowing safety and efficacy in amyotrophic lateral sclerosis

Pizzorni

Ginocchio

Bianchi

et al. 2020

Neurogastroenterology Motil

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Background Oropharyngeal dysphagia (OD) is common in amyotrophic lateral sclerosis (ALS), leading to a reduction of swallowing safety and efficacy. The tongue has an important role in swallowing function for oral processing and bolus propulsion through the pharynx. The study aims to analyze the association between instrumental findings of OD and tongue pressure. Methods Patients with ALS referred for fiberoptic endoscopic evaluation of swallowing (FEES) were recruited. FEES was conducted to test swallowing function with liquid (5, 10, and 20 ml), semisolid (5, 10, and 20 ml), and solid. FEES recordings were assessed for swallowing safety, using the penetration‐aspiration scale (PAS), and for swallowing efficacy, using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). PAS scores >2 were suggestive of penetration, PAS scores >5 of aspiration, and YPRSRS scores >2 of residue. Maximum tongue pressure (MTP) and tongue endurance were measured using the Iowa Oral Performance Instrument. Tongue pressure measurements were compared between patients with and without penetration, aspiration, or residue. Key results Fifty‐five patients with ALS were included. Mean MTP was 29.7 kPa, and median tongue endurance was 10 seconds. Patients with residue in the pyriform sinus had a significantly lower MTP than patients without residue in the pyriform sinus with semisolids 10 ml (P = .011) and 20 ml (P = .032). Patients with a tongue endurance <10 seconds exhibited higher frequency of penetration with liquids 5 ml (P = .046), liquids 10 ml (P = .015), and solids (P = .22). Conclusion and inferences In patients with ALS, MTP is significantly associated with an impairment of swallowing efficacy and tongue endurance was significantly associated with an impairment of swallowing safety.

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How Swallow Pressures and Dysphagia Affect Malnutrition and Mealtime Outcomes in Long-Term Care

Cited by 74 publications

References 34 publications

Dysphagia and factors associated with malnutrition risk: A 5‐year multicentre study

Dysphagia and factors associated with malnutrition risk: A 5‐year multicentre study

The Burden of Dysphagia on Family Caregivers of the Elderly: A Systematic Review

Association between maximum tongue pressure and swallowing safety and efficacy in amyotrophic lateral sclerosis

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