Abstract
There is evolving evidence for an association between dysphagia and sarcopenia in older adults. For optimizing the acute health care initiative across health care settings, this study investigated prevalence and time-course of dysphagia in older patients admitted to an emergency department (ED) as well as its association with parameters for probable sarcopenia, inactivity, malnutrition, disease status, and systemic inflammation. A secondary analysis of data from the FAM-CPH cohort study on acutely admitted older medical patients (n = 125). Data were collected upon ED admission as well as four and 56 weeks after discharge. Using the Eating Assessment Tool cut-off score ≥ 2, signs of dysphagia were present in 34% of the patients at ED admission and persisted in 25% of the patients 56 weeks after discharge. Signs of dysphagia at 56-week follow-up were significantly (p < 0.05) associated with probable sarcopenia (low handgrip strength (OR = 3.79), low leg muscle strength (OR = 8.14), and low physical performance (OR = 5.68)) and with baseline swallowing inactivity (OR = 5.61), malnutrition (OR = 4.35), and systemic inflammation (OR = 1.33). Signs of dysphagia in older patients admitted to an ED was prevalent, persisted 56 weeks after discharge, and was associated with probable sarcopenia and related conditions; all modifiable targets for management of dysphagia in older patients.
Highlights
Dysphagia in older adults is a frequent and serious condition that impairs swallowing efficiency and safety with increased risk of diminished nutritional intake and aspiration of foods and liquids [1,2]
In a large retrospective cohort study, Maeda et al [18] found that in older patients with normal swallow at admission, the risk of developing dysphagia during hospitalization was associated with indicators on sarcopenia, swallowing inactivity caused by diet restrictions with no oral intake or being on a texture modified diet, low performance status and immobilization, and low nutritional status
There was no difference in the EAT-10 scores between patients who completed and those lost to follow-up at 56 weeks
Summary
Dysphagia in older adults is a frequent and serious condition that impairs swallowing efficiency and safety with increased risk of diminished nutritional intake and aspiration of foods and liquids [1,2]. There is evolving evidence for an association between sarcopenia (low muscle strength, low muscle quantity or quality, and low physical performance) [9] and dysphagia in older adults [8,10,11]. In a large retrospective cohort study, Maeda et al [18] found that in older patients with normal swallow at admission, the risk of developing dysphagia during hospitalization was associated with indicators on sarcopenia, swallowing inactivity caused by diet restrictions with no oral intake or being on a texture modified diet, low performance status and immobilization, and low nutritional status. Dysphagia leads to reduced swallowing activity and malnutrition due to decreased food intake, which might induce or exacerbate sarcopenia [11]
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