Subjective dysphagia in older care home residents: A cross-sectional, multi-centre point prevalence measurement
Section snippets
Introduction and background
In a systematic review with homogeneity of cohort studies, dysphagia has been found to be strongly associated with aspiration pneumonia in frail older people (van der Maarel-Wierink et al., 2011). Aspiration pneumonia, an inflammatory condition of lung parenchyma usually initiated by the introduction of bacteria into the lung alveoli, is causing high hospitalization rates, morbidity, and often death in frail older people (Welte et al., 2012). Therefore, risk factors of aspiration pneumonia,
Methods
The LPZ survey design was a cross-sectional, multi-centre point prevalence measurement and was carried out on April 13 and November 2, 2010. Ethical approval was received from the medical ethical committee of the University Hospital of Maastricht. For this retrospective data analysis, data of care home residents aged 65 years or older were included. Tube-fed patients were excluded.
Based on literature findings, variables considered as potential risk factors of dysphagia were gender, age,
Results
In 2010, 119 (33%) out of the total number of 360 care homes in The Netherlands participated in the LPZ survey. Data of 8119 residents aged 65 years or older were analyzed. Table 1 shows the personal and health characteristics of the participating residents.
Subjective dysphagia was found in 751 (9%) residents (Table 2). Statistically significant results indicate that residents with dysphagia, when compared to residents without dysphagia, were younger, had lower Care Dependency Scale scores and
Discussion
In this survey, the prevalence of subjective dysphagia in care homes residents was 9%. The literature shows prevalence estimates of general (objective) dysphagia of 50–75% (Cabre et al., 2010, Marik and Kaplan, 2003). These estimates are based on three cross-sectional surveys, in which the prevalence rates of dysphagia varied from 13.7% to 97.5% (Kayser-Jones and Pengilly, 1999, Lin et al., 2002, Turley and Cohen, 2009). It seems reasonable to presume that objectively assessed dysphagia, as
Conclusion
Within the limitations of this cross-sectional, multi-centre point prevalence measurement, it seems justified to conclude that subjective dysphagia is a relevant care problem in older care home residents in the Netherlands. Care Dependency Scale score, ‘malnutrition’, and the disease clusters ‘dementia’, ‘nervous system disorder’, and ‘cerebrovascular disease/hemiparesis’ were associated with the presence of subjective dysphagia in this study. Age, ‘comorbidity’ and ‘cardiovascular disease’
References (36)
- et al.
Oropharyngeal dysphagia after stroke: incidence, diagnosis, and clinical predictors in patients admitted to a neurorehabilitation unit
J. Stroke Cerebrovasc. Dis.
(2009) - et al.
Prevalence of oropharyngeal dysphagia in Parkinson's disease: a meta-analysis
Parkinsonism Relat. Disord.
(2012) - et al.
Aspiration pneumonia and dysphagia in the elderly
Chest
(2003) - et al.
Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators
Nutrition
(2009) - et al.
Defining malnutrition: mission or mission impossible?
Nutrition
(2010) - et al.
Care problems and nursing interventions related to oral intake in German Nursing homes and hospitals: a descriptive multicentre study
Int. J. Nurs. Stud.
(2012) - et al.
Impact of voice and swallowing problems in the elderly
Otolaryngol. Head Neck Surg.
(2009) - et al.
Risk factors for aspiration pneumonia in frail older people: a systematic literature review
J. Am. Med. Dir. Assoc.
(2011) - et al.
Daily oral care and cough reflex sensitivity in elderly nursing home patients
Chest
(2004) - et al.
Dysphagia is a common and serious problem for adults with mental illness: a systematic review
Dysphagia
(2012)
Modification of the risk of mortality from pneumonia with oral hygiene care
J. Am. Geriatr. Soc.
Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia
Age Ageing
Feeding difficulty in older adults with dementia
J. Clin. Nurs.
Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population
Dysphagia
A reliability and utility study of the care dependency scale
Scand. J. Caring Sci.
Diagnostic accuracy of the care dependency scale
J. Adv. Nurs.
Identification of the cerebral loci processing human swallowing with H2(15)O PET activation
J. Neurophysiol.
Swallowing in Alzheimer's disease
Alzheimer Dis. Assoc. Disord.
Cited by (35)
Factors related to dysphagia-specific quality of life in aged patients with neurologic disorders: A cross-sectional study
2022, Geriatric NursingCitation Excerpt :With aging, the swallowing function decreases along with the deterioration of body functions.19 Furthermore, the older adults with neurological diseases are more prone to swallowing disturbance than those without.17,20,21 It may also have more dangerous and fatal consequences for the older adults with the disease than without.22
Dysphagia screening in residential care settings: A scoping review
2021, International Journal of Nursing StudiesOropharyngeal Dysphagia in Community-Dwelling Older Patients with Dementia: Prevalence and Relationship with Geriatric Parameters
2018, Journal of the American Medical Directors AssociationDysphagia in Nursing Homes—Results From the NutritionDay Project
2018, Journal of the American Medical Directors AssociationCitation Excerpt :This is reflected in our study as residents with dysphagia were more often dehydrated and is consistent with a previous report on NH residents where 75% with dysphagia had signs of dehydration.32 In addition to the expected risk factors of dysphagia such as impaired cognitive10–12 and functional status,8,10,11 we found that having digestive diseases and the use of antibiotics were also associated with a higher risk of dysphagia. The higher antibiotic intake in residents with dysphagia might indicate that these residents were treated for infections because of aspiration pneumonia in consequence of their dysphagia.
Nursing home-acquired pneumonia, dysphagia and associated diseases in nursing home residents: A retrospective, cross-sectional study
2017, Geriatric NursingCitation Excerpt :Nonetheless, cognitive decline or impairment, such as dementia, will influence the individual ability of nursing home residents and nurses to interpret the symptoms of swallowing problems.24 Furthermore, residents of Dutch nursing homes did recognize their swallowing problems (subjective dysphagia), but considered their swallowing problems to be a natural symptom of aging or of their diseases.25 Owing to this decreased ability to interpret symptoms and the perception of swallowing problems as a natural symptom of aging, dysphagia might not be recognized in time, which increases the risk of aspiration pneumonia amongst these people.