Dysphagia among Older Patients in a Teaching Hospital, Selangor
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Abstract
Introduction: The number of older adults suffering from dysphagia (difficulty in swallowing) has been increasing over the years. This is genuinely concerning as dysphagia may affect one's quality of life, which can then lead to death if left untreated. This study aimed to determine the factors associated with socio-demographic, medical background, anthropometry, dietary intake, risk of malnutrition, and functional status with dysphagia among older patients in Hospital Sultan Abdul Aziz Shah (HSAAS). Materials and methods: This cross-sectional study was conducted among subjects aged 60 and older in Hospital Sultan Abdul Aziz Shah (HSAAS), Universiti Putra Malaysia (UPM), Serdang, using purposive sampling. A set of questionnaires containing seven sections which included sociodemographics, anthropometry, medical background, dietary intake, risk of malnutrition, functional status, and presence of dysphagia were distributed. Meanwhile, Pearson’s chi-square test and Fisher’s Exact Test were used to determine the association between variables. Results: 104 eligible subjects joined this study with a mean age of 69.4 years (6.7 years). Out of 104 subjects, 11.5% were reported to have dysphagia. Based on the statistical analysis, significant associations were found between marital status (p= 0.011), BMI (p= 0.028), dietitian referral (p>0.001), energy adequacy (p= 0.008), protein adequacy (p= 0.004) and risk of malnutrition (p= 0.008) with dysphagia. Conclusion: This study investigated the prevalence and factors associated with dysphagia among older adults in HSAAS. The results revealed an 11.5% prevalence of dysphagia, with significant associations found between dysphagia and marital status, BMI, dietitian referral, energy and protein adequacy, and malnutrition risk. These findings underscore the importance of comprehensive dysphagia management involving multidisciplinary healthcare teams to address nutritional deficiencies and improve patient outcomes.
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Thiyagalingam S, Kulinski AE, Thorsteinsdottir B, Shindelar KL, Takahashi PY. Dysphagia in Older Adults. Vol. 96, Mayo Clinic Proceedings. Elsevier Ltd; 2021. p. 488–97. doi:10.1016/j.mayocp.2020.08.001
Aslam M, Vaezi MF. Dysphagia in the Elderly. Gastroenterol Hepatol (N Y). 2013;9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999993/
Madhavan A, Lagoria LA, Crary MA, Dahl WJ, Cranaby GD. Prevalence of And Risk Factors for Dysphagia in The Community Dwelling: A Systematic Review. 2015.
doi: 10.1007/s12603-016-0712-3
Popman A, Richter M, Allen J, Wham C. High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital. Nutrition and Dietetics. 2018;75(1):52–8. doi:10.1111/1747-0080.12385
Bomze L, Dehom S, Lao WP, Thompson J, Lee N, Cragoe A, et al. Comorbid Dysphagia and Malnutrition in Elderly Hospitalized Patients. Laryngoscope. 2021;131(11):2441–7. doi: 10.1002/lary.29329
Maeda K, Akagi J. Sarcopenia is an independent risk factor of dysphagia in hospitalised older people. Geriatr Gerontol Int. 2016;16(4):515–21. doi:10.1111/ggi.12486
Husmeela H, Kartini A, Zakinah Y, Sharifa Ezat WP, Hasherah MI. Med J Malaysia. 2021 [cited 2022 Sep 27]. p. 837–44 The prevalence of dysphagia among head and neck cancer patients in tertiary public hospitals in Malaysia - PubMed. Available from: https://pubmed.ncbi.nlm.nih.gov/34806670/
Neelagandan AI, Tuin E, Tay CY, Muniandy RK. An Audit of Dysphagia Patients Attending Speech Therapy Clinic at a Tertiary Hospital in Malaysia. Borneo Journal of Medical Sciences. 2021;15(1):21–9. doi: 10.51200/bjms.v15i1.2365
Gallegos C, Brito-de la Fuente E, Clavé P, Costa A, Assegehegn G. Nutritional Aspects of Dysphagia Management. In: Advances in Food and Nutrition Research. Academic Press Inc.; 2017. p. 271–318. doi: 10.1016/bs.afnr.2016.11.008
Byun SE, Kwon KB, Kim SH, Lim SJ. The prevalence, risk factors and prognostic implications of dysphagia in elderly patients undergoing hip fracture surgery in Korea. BMC Geriatr [Internet]. 2019 [cited 2022 Nov 17];19(1). Available from: https://pubmed.ncbi.nlm.nih.gov/31852457/
Mann T, Heuberger R, Wong H. The association between chewing and swallowing difficulties and nutritional status in older adults. Aust Dent J. 2013;58(2):200–6.
doi: 10.1111/adj.12064
Lee SH, Gong HS. Measurement and interpretation of handgrip strength for research on sarcopenia and osteoporosis. Vol. 27, Journal of Bone Metabolism. Korean Society for Bone and Mineral Research; 2020. p. 85–96. doi: 10.11005/jbm.2020.27.2.85
Nagayoshi M, Higashi M, Takamura N, Tamai M, Koyamatsu J, Yamanashi H, et al. Social networks, leisure activities and maximum tongue pressure: cross-sectional associations in the Nagasaki Islands Study. BMJ Open [Internet]. 2017 [cited 2022 Dec 27];7(12). Available from: https://pubmed.ncbi.nlm.nih.gov/29217718/
Watanabe K, Umegaki H, Huang CH, Arakawa Martins B, Asai A, Kanda S, et al. Association between dysphagia risk and unplanned hospitalisation in older patients receiving home medical care. Geriatr Gerontol Int [Internet]. 2019 [cited 2022 Nov 17];19(10):977–81. Available from: https://pubmed.ncbi.nlm.nih.gov/31415130/
Sakamoto Y, Oyama G, Umeda M, Funahara M, Soutome S, Nakamura W, et al. Effect of decreased tongue pressure on dysphagia and survival rate in elderly people requiring long-term care. J Dent Sci. 2022;17(2):856–62. doi: 10.1016/j.jds.2021.09.031
Wolf U, Eckert S, Walter G, Wienke A, Bartel S, Plontke SK, et al. Prevalence of oropharyngeal dysphagia in geriatric patients and real-life associations with diseases and drugs. Sci Rep. 2021;11(1). doi:10.1038/s41598-021-99858-w
Yang EJ, Kim MH, Lim JY, Paik NJ. Oropharyngeal Dysphagia in a Community-Based Elderly Cohort: the Korean Longitudinal Study on Health and Aging. 2013; doi:10.3346/jkms.2013.28.10.1534
Lim Y, Kim C, Park H, Kwon S, Kim O, Kim H, et al. Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea. Nutr Res Pract. 2018;12(5):406–14. doi:10.4162/nrp.2018.12.5.406
Ko D, Oh J, Joo S, Park JY, Cho MS. Dietary Habits, Food Product Selection Attributes, Nutritional Status, and Depression in Middle-Aged and Older Adults with Dysphagia. Nutrients. 2022;14(19):4045. doi:10.3390/nu14194045
da Silva AF, Moreira EAM, Barni GC, Panza VSP, Furkim AM, Moreno YMF. Relationships between high comorbidity index and nutritional parameters in patients with Oropharyngeal Dysphagia. Clin Nutr ESPEN [Internet]. 2020 [cited 2022 Dec 20];38:218–22. doi:10.1016/j.clnesp.2020.04.008
Ko D, Oh J, Joo S, Park JY, Cho MS. Dietary Habits, Food Product Selection Attributes, Nutritional Status, and Depression in Middle-Aged and Older Adults with Dysphagia. Nutrients. 2022;14(19). doi:10.3390/nu14194045
Wakabayashi H, Takahashi R, Murakami T. The Prevalence and Prognosis of Sarcopenic Dysphagia in Patients Who Require Dysphagia Rehabilitation. The journal of nutrition, health & aging 2018 23:1.doi: 10.1007/s12603-018-1117-2
Matsuo H, Yoshimura Y, Ishizaki N, Ueno T. Dysphagia is associated with functional decline during acute-care hospitalisation of older patients. Geriatr Gerontol Int. 2017;17(10):1610–6. doi:10.1111/ggi.12941
Poisson P, Laffond T, Campos S, Dupuis V, Bourdel-Marchasson I. Relationships between oral health, dysphagia and undernutrition in hospitalised elderly patients. Gerodontology [Internet]. 2016 [cited 2023 Feb 21];33(2):161–8. doi: 10.1111/ger.12123
de Sire A, Ferrillo M, Lippi L, Agostini F, de Sire R, Ferrara PE, et al. Sarcopenic Dysphagia, Malnutrition, and Oral Frailty in Elderly: A Comprehensive Review. Vol. 14, Nutrients. MDPI; 2022. doi:10.3390/nu14050982
Silva LM de L, Lima CR de, Cunha DA da, Orange LG de. Dysphagia and its relation with nutritional status and calorie/protein intake in the elderly. Revista CEFAC. 2019;21(3). doi: 10.1590/1982-0216/201921315618
Tran TP, Nguyen LT, Hirose K, Nguyen TH, Le HT, Shimura F, et al. Malnutrition is associated with dysphagia in Vietnamese older adult inpatients. Asia Pac J Clin Nutr. 2021;30(4):588–94. doi:10.3316/informit.291935726109795
Fernández-Ruiz VE, Paredes-Ibáñez R, Armero-Barranco D, Sánchez-Romera JF, Ferrer M. Analysis of Quality of Life and Nutritional Status in Elderly Patients with Dysphagia in Order to Prevent Hospital Admissions in a COVID-19 Pandemic. Life [Internet]. 2021 [cited 2022 Nov 23];11(1):1–16. doi:10.3390/life11010022
Publisher – Metro North Hospital O, Service – Queensland Government H. Using Body Mass Index – Metro North Hospital and Health Service. [cited 2023 Feb 5]; Available from: http://www.health.qld.gov.au/masters/copyright.asp
Kaluźniak‐szymanowska A, Krzymińska‐siemaszko R, Lewandowicz M, Deskur‐śmielecka E, Stachnik K, Wieczorowska‐tobis K. Diagnostic performance and accuracy of the MNA-SF against GLIM criteria in community-dwelling older adults from Poland. Nutrients, 13(7), 2183. doi: 10.3390/nu13072183
Xue H, Yang M, Liu Y, Duan R, Cheng G, Zhang X. Relative validity of a 2‐day 24‐hour dietary recall compared with a 2‐day weighed dietary record among adults in South China. Nutrition & dietetics, 74(3), 298-307. doi:10.1111/1747-0080.12315