Factors Associated with Aspiration Risk among Geriatric Patients with Dysphagia

Abstract

Dysphagia is considered a serious problem affecting geriatric patients because of the increased risk of aspiration. Dysphagia and risk for aspiration is a geriatric syndrome that should be screened early and treated in all hospital admitted geriatric patients in order to reduce morbidity and length of hospital stay. Objective: Identify the factors associated with aspiration risk among geriatric patients with dysphagia. Setting: The study was carried out in the Medical Units of the Main University Hospital, Alexandria, Egypt. Subjects: The study included 100 geriatric patients with dysphagia admitted to the selected units and fulfilling the following criteria; age 60 years and more, with no contraindication for oral feeding, able to maintain sitting position, able to communicate and available at the time of data collection. Tools: Four tools were used for data collection: 1) Gugging Swallowing Screen (GUSS), 2) Socio-demographic and clinical data of geriatric patients with dysphagia structured interview schedule, 3) Factors associated with aspiration risk among geriatric patients with dysphagia structured interview schedule, 4) Barthel Index. Results: Severe dysphagia with a high risk of aspiration was observed in 37.0% of the study geriatric patients, while moderate dysphagia with a risk of aspiration in 27.0% and those who had slight dysphagia with a low risk of aspiration in 36.0%.The severity of dysphagia and aspiration risk is affected significantly by living arrangement, level of dependency, receiving chemotherapy treatment, mouth dryness and weak tongue movement as a side effects of medication. Conclusion: The severity of dysphagia and aspiration risk were affected by several factors as filing mouth with foods, feeling tired and fatigued during meals. Moreover, dysphagia and aspiration risk were associated with illiteracy and specific medical diagnosis as hypertension, heart failure and leukemia. Recommendations: Comprehensive assessment of geriatric patients for dysphagia and aspiration risk should be a routine and basic procedure of the gerontological nurse in order to identify early those at risk and implement appropriate nursing interventions to prevent complications.