Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia

Autor: Elisabet Palomera, Amparo Elvira, Mᵃ Carmen Espinosa-Val, Alberto Martin-Martinez, Mateu Cabré, Pere Clavé, Omar Ortega, Mercè Graupera, Mireia Bolivar-Prados, Olivia Arias
Rok vydání: 2020
Předmět:
Male
Comorbidity
0302 clinical medicine
Risk Factors
Odds Ratio
Prevalence
alzheimer disease
follow-up
swallowing disorders
Prospective Studies
030212 general & internal medicine
Aged
80 and over
education.field_of_study
Nutrition and Dietetics
Age Factors
Prognosis
Hospitalization
Female
Disease Susceptibility
medicine.symptom
Alzheimer's disease
lcsh:Nutrition. Foods and food supply
medicine.medical_specialty
Population
lcsh:TX341-641
elderly
Oral hygiene
Article
respiratory infections
03 medical and health sciences
Swallowing
Internal medicine
medicine
Humans
Dementia
education
Geriatric Assessment
Aged
business.industry
Swallowing Disorders
medicine.disease
mortality
Malnutrition
Spain
Deglutition Disorders
business
030217 neurology & neurosurgery
dementia
Food Science
Oropharyngeal dysphagia
Zdroj: Nutrients, Vol 12, Iss 3, p 863 (2020)
Nutrients
Volume 12
Issue 3
ISSN: 2072-6643
DOI: 10.3390/nu12030863
Popis: The prevalence of older patients with dementia and oropharyngeal dysphagia (OD) is rising and management is poor. Our aim was to assess the prevalence, risk factors, and long-term nutritional and respiratory complications during follow-up of OD in older demented patients. We designed a prospective longitudinal quasi-experimental study with 255 patients with dementia. OD was assessed with the Volume-Viscosity Swallowing Test and a geriatric evaluation was performed. OD patients received compensatory treatments based on fluid viscosity and texture modified foods and oral hygiene, and were followed up for 18 months after discharge. Mean age was 83.5 ±
8.0 years and Alzheimer&rsquo
s disease was the main cause of dementia (52.9%). The prevalence of OD was 85.9%. Up to 82.7% patients with OD required fluid thickening and 93.6% texture modification, with poor compliance. OD patients were older (p <
0.007), had worse functionality (p <
0.0001), poorer nutritional status (p = 0.014), and higher severity of dementia (p <
0.001) than those without OD and showed higher rates of respiratory infections (p = 0.011) and mortality (p = 0.0002) after 18 months follow-up. These results show that OD is very prevalent among patients with dementia and is associated with impaired functionality, malnutrition, respiratory infections, and increased mortality. New nutritional strategies should be developed to increase the compliance and therapeutic effects for this growing population of dysphagic patients.
Databáze: OpenAIRE
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