Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study

• Published in: Age and ageing Vol. 41; no. 3; pp. 376 - 381
• Main Authors: Serra-Prat, M., Palomera, M., Gomez, C., Sar-Shalom, D., Saiz, A., Montoya, J. G., Navajas, M., Palomera, E., Clave, P.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2012; Oxford Publishing Limited (England)
• Subjects: Age Factors; Aged; Aged, 80 and over; Aging; At risk; Causes of; Chi-Square Distribution; Clinical outcomes; Comorbidity; Deglutition; Deglutition disorders; Deglutition Disorders - diagnosis; Deglutition Disorders - epidemiology; Deglutition Disorders - physiopathology; Diagnosis; Dysphagia; Efficacy; Female; Geriatric Assessment; Hand Strength; Humans; Incidence; Independent Living; Logistic Models; Lower respiratory tract infection; Male; Malnutrition; Malnutrition - diagnosis; Malnutrition - epidemiology; Malnutrition - physiopathology; Nutrition Assessment; Nutritional Status; Odds Ratio; Older people; Prevalence; Prospective Studies; Respiratory diseases; Respiratory tract infections; Respiratory Tract Infections - diagnosis; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - physiopathology; Risk Assessment; Risk Factors; Safety; Spain - epidemiology; Time Factors; Spain
• ISSN: 0002-0729; 1468-2834; 1468-2834
• DOI: 10.1093/ageing/afs006

to assess the role of oropharyngeal dysphagia (OD) as a risk factor for malnutrition and/or lower respiratory tract infection (LRTI) in the independently-living population of 70 years and over. a population-based cohort study. persons 70 years and over in the community (non-institutionalised) were randomly selected from primary care databases. the volume-viscosity swallow test (V-VST) was administered by trained physicians at baseline to identify subjects with clinical signs of OD and impaired safety or efficacy of swallow. At the one year follow-up visit, hand grip, functional capacity (Barthel score), nutritional status (mini nutritional assessment, MNA) and LRTI (clinical notes) were assessed. two hundred and fifty-four subjects were recruited (46.5% female; mean age, 78 years) and 90% of them (227) were re-evaluated one year later. Annual incidence of 'malnutrition or at risk of malnutrition' (MNA <23.5) was 18.6% in those with basal signs of OD and 12.3% in those without basal signs of OD (P = 0.296). However, prevalent cases of 'malnutrition or at risk of malnutrition' at follow up were associated with basal OD (OR = 2.72; P = 0.010), as well as with basal signs of impaired efficacy of swallow (OR = 2.73; P = 0.015). Otherwise, LRTI's annual incidence was higher in subjects with basal signs of impaired safety of swallow in comparison with subjects without such signs (40.0 versus 21.8%; P = 0.030; OR = 2.39). OD is a risk factor for malnutrition and LRTI in independently living older subjects. These results suggest that older persons should be routinely screened and treated for OD to avoid nutritional and respiratory complications.