Abstract
ObjectivesNursing home residents often suffer from multi-morbidities and geriatric syndromes leading to lower quality of life or mortality. Oropharyngeal dysphagia (OD) and malnutrition are profound conditions in this complex profile of multi-morbidities and are associated with deprived mental –and physical health status, e.g. aspiration pneumonia or dehydration. This study aimed to assess the association between OD and malnutrition in Dutch nursing home residents.DesignData for this cross-sectional study were obtained from the annual National Prevalence Measurement of Quality of Care (LPZ).SettingThe National Prevalence Measurement of Quality of Care was conducted in Nursing Homes in The Netherlands.ParticipantsParticipants were nursing home residents age 65 or older and admitted to psychogeriatric- or somatic wards.MeasurementsThe measurements were taken by trained nurses from the participating nursing homes. Anthropometric measurements and unintended weight loss (%) were assessed to determine nutritional status (malnutrition). OD was assessed by means of a standardized questionnaire assessing clinically relevant symptoms of OD such as swallowing problems or sneezing/coughing while swallowing. Cox regression was applied to assess the association between malnutrition and clinically relevant symptoms of OD in older Dutch nursing home residents.ResultsApproximately 12% of the residents suffered from swallowing problems and 7% sneezed/coughed while swallowing liquids or solid foods. Approximately 10% of the residents was malnourished. Residents with OD symptoms were more often malnourished compared to residents without OD symptoms. Approximately 17% of the problematic swallowers were concurrently malnourished. Increased risk for malnutrition was found in residents suffering from swallowing problems (PR 1.5, 95%CI 1.2–1.9), as well as in residents that sneezed/ coughed while swallowing (PR 1.3, 95%CI 1.0–1.7). Stratification based on wards revealed that problematic swallowers from somatic wards were at a high risk of malnutrition (PR 1.9, 95%CI 1.3–2.8).ConclusionClinically relevant symptoms of oropharyngeal dysphagia, such as swallowing problems and sneezing/coughing while swallowing are associated with increased risk of malnutrition in psychogeriatric and somatic Dutch nursing home residents.
Highlights
Nursing home residents often suffer from multi-morbidities and geriatric syndromes leading to lower quality of life or mortality
Oropharyngeal dysphagia (OD) and malnutrition are silent dysphagia [9, 10]) or left untreated, they may lead to conditions that result in lower quality of life and that place aspiration pneumonia or dehydration respectively [11,12,13,14] or people at high risk for co-morbidities and mortality
Impaired eating behaviour could be a consequence in nursing home residents [2, 3], especially in residents who of dementia or depression [17, 18] and swallowing capacity or suffer from stroke [4], dementia [5], or from other illnesses nutritional status may be influenced by side effects of certain or treatments that affect the swallowing mechanism [6]. antipsychotic drugs [19, 20]
Summary
Objectives: Nursing home residents often suffer from multi-morbidities and geriatric syndromes leading to lower quality of life or mortality. Cox regression was applied to assess the association between malnutrition and clinically relevant symptoms of OD in older Dutch nursing home residents. Conclusion: Clinically relevant symptoms of oropharyngeal dysphagia, such as swallowing problems and sneezing/coughing while swallowing are associated with increased risk of malnutrition in psychogeriatric and somatic Dutch nursing home residents. Impaired eating behaviour could be a consequence in nursing home residents [2, 3], especially in residents who of dementia or depression [17, 18] and swallowing capacity or suffer from stroke [4], dementia [5], or from other illnesses nutritional status may be influenced by side effects of certain or treatments that affect the swallowing mechanism [6]. OD and malnutrition complicate care in older nursing by Streicher et al (2017) reported prevalence rates of OD up home residents in view of associated health complications, to 48% using a standardised questionnaire in nursing home
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