Prevalence and risk factors of dysphagia among nursing home residents in eastern China: a cross-sectional study

Abstract

Background Dysphagia is a common health care problem and poses significant risks including mortality and hospitalization. China has many unsolved long-term care problems, as it is a developing country with the largest ageing population in the world. The present study aimed to identify the prevalence and risk factors of dysphagia among nursing home residents in China to direct caregivers towards preventative and corrective actions. Methods Data were collected from 18 public or private nursing homes in 9 districts of Nanjing, China. A total of 775 older adults (aged 60 ~ 105 years old; 60.6% female) were recruited. Each participant underwent a standardized face-to-face interview by at least 2 investigators. The presence of risk of dysphagia was assessed using the Chinese version of the EAT-10 scale. The Barthel Index (BI) was used to evaluate functional status. Additionally, demographic and health-related characteristics were collected from the participants and their medical files. Univariate analyses were first used to find out candidate risk factors, followed by binary logistic regression analyses to determine reliable impact factors after adjusting for confounders. Results Out of 775 older adults, the prevalence of dysphagia risk was calculated to be 31.1%. A total of 85.0% of the older adults reported at least one chronic disease, and diseases with the highest prevalence were hypertension (49.5%), stroke (40.4%), diabetes (25.5%) and dementia (18.2%). Approximately 11.9% of participants received tube feeding. The mean BI score was 56.2 (SD = 38.3). Risk factors for dysphagia were texture of diet (OR = 2.978, p ≤ 0.01), BI level (OR = 1.418, p ≤ 0.01), history of aspiration, pneumonia and heart attack (OR = 22.962, 4.909, 3.804, respectively, p ≤ 0.01), types of oral medication (OR = 1.723, p ≤ 0.05) and Parkinson disease (OR = 2.566, p ≤ 0.05). Conclusions A serious risk of dysphagia was observed among Chinese nursing home residents. Overall, nursing home residents were moderately dependent, according to the BI level. The risk for dysphagia increased with thinner diet texture, worse functional status, history of aspiration, pneumonia and heart attack, more oral medications and Parkinson disease. The findings of our study may serve to urge nursing home staff to pay more attention to the swallowing function of all residents and to take more actions in advance to prevent or reduce dysphagia.

Associations of Oral Health-Related Quality of Life with age, oral status, and oral function among psychiatric inpatients in Japan: a cross-sectional study

“…Third, suspected dysphagia was defined based on the EAT-10 in the questionnaire survey and not on a clinical diagnosis. Some recent studies using the EAT-10 questionnaire for the screening of suspected dysphagia among elderly people reported that the reliability and validity of the questionnaire were excellent [ 33 , 57 – 59 ]. However, if the questionnaire was used with psychiatric patients, the reliability and validity of the questionnaire might be reduced.…”

Nursing home staff perceptions of challenges and coping strategies during COVID-19 pandemic in China

“…Compared with other developing countries, China has a larger ageing population and relatively less developed long-term care systems, with different policies and standards. 6 In 2019, there were 204,000 nursing homes, with a total of 7.75 million beds. 7 Only 1.5% to 2.0% of people aged 65 and over living in nursing homes, which is a lower institutional care rate compared with 4% to 8% in Western countries.…”

Associations of Oral Health-Related Quality of Life with Age, Oral Status, and Oral Function among Psychiatric Inpatients in Japan: a cross-sectional study

“…Third, suspected dysphagia was de ned based on the EAT-10 in the questionnaire survey and not on a clinical diagnosis. Some recent studies using the EAT-10 questionnaire for the screening of suspected dysphagia among elderly people reported that the reliability and validity of the questionnaire were excellent [34,[58][59][60]. However, if the questionnaire was used with psychiatric patients, the reliability and validity of the questionnaire might be reduced.…”

“…There are ve response categories with an associated score (l=always, 2=often, 3=sometimes, 4=seldom, and 5=never). The GOHAI score is computed by summing the scores of the 12 responses, and the highest score (60) indicates excellent oral health.…”