Nonimaging Clinical Assessment of Impaired Swallowing in Community-Dwelling Older Adults in Taiwan

Chen, Miao‐Yen; Lin, Li‐Chan

doi:10.1097/jnr.0b013e31827364ec

Cited by 14 publications

(8 citation statements)

References 18 publications

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“…Thirty-four used only one method to estimate SI frequency: three used objective instrumental assessments [4,33,34], seven water and saliva test [22-24, 37, 39, 43], seventeen a screening instrument [18-20, 25, 29, 30, 36, 40, 41, 45-47, 49-51, 54], and seven self-perception [3,16,21,26,38,42,48]. Seven studies presented the estimated frequency of SI by more than one assessment method: one presented by all subtypes [17], two by objective assessment, water test, and a screening instrument [28,37], and four presented by water test and a screening instrument [27,32,44,53]. The lowest estimated frequency of SI was found by Zhang H. et al 2020 [44], 5.5% assessed by Eating Assessment Tool (EAT-10), followed by Mulheren et al 2018 [28], 6.4%, assessed by videofluoroscopy and Penetration/Aspiration Scale in the USA.…”

Section: Resultsmentioning

confidence: 99%

“…Some included studies showed frequency data by more than one assessment method. Six studies [4,17,26,[31][32][33] showed data for objective measures, thirteen for water test or saliva [17, 22-24, 26-28, 32, 35, 37, 39, 43, 44, 53], twentyfive for screening questionnaires [17-20, 25, 27-32, 35, 36, 40, 41, 44-47, 49-54], and nine for single-item self-report [3,16,17,21,26,31,38,42,48]. The pooled effect for each assessment method is shown in Fig.…”

Section: Frequency By Assessment Methodsmentioning

confidence: 99%

“…Thirty factors considered both sexes and thirteen stratified by sex as male and female. Meta-analysis was performed for the factors repeated in more than one study, namely age (continuous) [17,[23][24][25], diabetes mellitus (presence) [23], sex (female) [23][24][25], and number of drugs (continuous) [25,53]. Their estimated pooled effect was grouped with the effect measures of the other factors in Fig.…”

Section: Factors Associated With Swallowing Impairmentmentioning

confidence: 99%

“…al. 2018[28] and Chen et al 2012[17], and the frequency estimated becomes 38.22% (95%CI 33.00-43.71, 95%PI 27.29-50.48, I 2 0%, k = 4, n = 314). Pooled frequency of SI from water tests was 14.60% (95%CI 10.30-20.28%; 95%PI 3.52-44.48, I 2 = 98.0%, k = 13, n = 13,361-Fig.…”

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confidence: 92%

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Frequency and associated factors for swallowing impairment in community-dwelling older persons: a systematic review and meta-analysis

et al. 2022

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Introduction Swallowing impairment (SI) is an underdiagnosed dysfunction frequently seen as an expected condition of aging. However, SI can lead to health complications and considerable social impact. Methods The objective of this systematic review with meta-analysis was to evaluate the frequency and associated factors with SI in community-dwelling older persons. Searches were performed in 13 electronic databases including MEDLINE and EMBASE (from inception to September 18, 2021). Data extraction and methodological quality assessment of included studies were performed by two independent reviewers. Meta-analysis of proportions with 95% confidence interval (CI) and prediction interval (PI) was used to pool estimates. Subgroup analysis by Country and Assessment Method was performed. General meta-analysis was used to pool measures of association between potential risk factors and SI occurrence (odds ratio [OR] or prevalence ratio [PR]). ResultsThe worldwide estimated frequency of SI in community-dwelling older persons was 20.35% (95%CI 16.61-24.68%, 95%PI 4.79-56.45, I 2 99%, n = 33,291). This estimation varied across assessment methods and by country. The main factors associated with SI were a dry mouth (OR 8.1, 95%CI 4.9-13.4), oral diadochokinesis (OR 5.3, 95%CI 1.0-27.3), ≥ 80 years old (OR 4.9, 95%CI 2.6-9.2), genetic factor (SNPrs17601696) (OR 4.8,, and partial dependence (OR 4.3, 95%CI 2.0-9.3). And the main factors associated with SI estimated by PR were dry mouth sensation (PR 4.1, 95%CI 2.6-6.5), oral sensorimotor alteration (PR 2.6, 95%CI 1.4-4.9), osteoporosis (PR 2.51, 95%CI 1.2-5.3), and heart diseases (PR 2.31, 95%CI 1.1-5.0). Conclusion One in five older adults worldwide are expected to experience SI and factors associated with this underdiagnosed dysfunction included biological and physiological changes related to aging, physical and psychological conditions, and poor oral health. Early assessment is paramount for the prevention of future clinical complications and should be a high priority in health care practices.

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Section: Resultsmentioning

confidence: 99%

Section: Frequency By Assessment Methodsmentioning

confidence: 99%

Section: Factors Associated With Swallowing Impairmentmentioning

confidence: 99%

mentioning

confidence: 92%

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Frequency and associated factors for swallowing impairment in community-dwelling older persons: a systematic review and meta-analysis

et al. 2022

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“…Of these, 11.8 million older adults live alone and may be considered CDOA [3,6]. A growing body of evidence suggests CDOA are at risk for developing dysphagia with potential prevalence rates as high as 35% [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. These conservative estimates suggest that within the US alone, CDOA at risk for developing dysphagia may be in excess of 4 million.…”

Section: Introductionmentioning

confidence: 99%

Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults

et al. 2018

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Evidence suggests that community dwelling older adults (CDOA) are at risk for dysphagia (swallowing difficulties). Dysphagia is often unidentified until related morbidities like under nutrition or pneumonia occur. These cases of unidentified dysphagia, prior to any clinical intervention, may be termed ‘pre-clinical dysphagia’. Identifying pre-clinical dysphagia is challenged by the lack of validated tools appropriate for CDOA. This study addresses preliminary development of a novel patient reported outcome (PRO) screening tool for pre-clinical dysphagia. Initially, 34 questions were developed from literature review and expert opinion. Following pilot testing (n = 53), the questionnaire was revised and tested on 335 additional CDOA. Face validity, content validity, item analysis, reliability (internal consistency), and construct validity (exploratory factor analysis) measures were completed. Psychometric validation resulted in a 17-question PRO tool. Construct analysis identified a three-factor model that explained 67.345% of the variance. Emergent factors represented swallowing effort, physical function, and cognitive function. The results revealed strong construct validity and internal consistency (Cronbach’s α = 0.90). A novel, simple PRO incorporating multiple function domains associated with aging demonstrated strong preliminary psychometric properties. This tool is more comprehensive and aging-focused than existing dysphagia screening tools. Inclusion of multiple domains may be key in early identification of pre-clinical dysphagia.

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Surface Electromyography for Evaluating the Effect of Aging on the Coordination of Swallowing Muscles

Chang¹,

Chen²,

Liu³

et al. 2023

Dysphagia

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Swallowing function can deteriorate with age, leading to a risk of dysphagia. Swallowing evaluation by surface electromyography (sEMG) can be easily and extensively applied for an elderly population. This study evaluated the temporal events observed by sEMG to clarify how aging affects the coordination among the masticatory and suprahyoid muscles. We recruited elderly individuals (over 65 years old) who denied dysphagia. The sEMG activities of anterior temporalis, masseter, and suprahyoid muscles were recorded during 3, 15, and 30 ml water swallowing tests (WST). We calculated the time interval between anterior temporalis and suprahyoid peak activity (T-SH interval) and masseter and suprahyoid peak activity (M-SH interval) and analyzed their correlation with age. The subjects who could and could not swallow 30 ml of water in one gulp were further assigned into the one-gulp and piecemeal groups, respectively, for subgroup analysis. We recruited 101 subjects, among whom 75 (26 males and 49 females) were analyzed after excluding those with suspected dysphagia or low-quality sEMG recordings. Age was significantly correlated with the bilateral T-SH (left: r = 0.249, p = 0.031; right: r = 0.412, p < 0.01) and right M-SH (r = 0.242, p = 0.037) intervals in the 30 ml WST. The correlation between intervals and age were observed in both subgroups. sEMG can be used to investigate the effect of aging on the temporal coordination between masticatory and suprahyoid contraction. Further studies are needed to verify the validity of screening subclinical dysphagia in the elderly.

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Nonimaging Clinical Assessment of Impaired Swallowing in Community-Dwelling Older Adults in Taiwan

Cited by 14 publications

References 18 publications

Frequency and associated factors for swallowing impairment in community-dwelling older persons: a systematic review and meta-analysis

Frequency and associated factors for swallowing impairment in community-dwelling older persons: a systematic review and meta-analysis

Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults

Surface Electromyography for Evaluating the Effect of Aging on the Coordination of Swallowing Muscles

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