Factors predicting the effects of dysphagia rehabilitation on multidimensional functional status in elder outpatients: A prospective cohort study.

Abstract

This study aimed to clarify the relationship between the oral intake function and functional status, as well as to determine the aspects of functional status potentially predicting the effects of dysphagia rehabilitation in the maintenance stage, in elder outpatients. This study was conducted in a clinic, specialised in rehabilitation of patients with dysphagia. The participants were 93 non-tube-fed patients 65years of age or older. The participants were scheduled to undergo the initial examination for oral intake function and functional status, and then to receive dysphagia rehabilitation for 1year. After rehabilitation period, oral intake function was re-evaluated, and the elements of functional status potentially related to the effects of dysphagia rehabilitation were determined. It was found that the lower the participants' oral intake function levels, the higher the prevalence of reduced parameters of functional status. After 1-year dysphagia rehabilitation, the oral intake function was maintained or improved in 70 (75.3%) participants, but had diminished in 23 (24.7%). Our analysis revealed that participants with higher Vitality Index scores and MMSE at the time of initial examination were significantly more likely to show maintained or improved oral intake function at 1year (odds ratio[OR], 1.76; 95% confidence interval [CI], 1.14-2.71; OR, 1.17; 95% CI, 1.06-1.28, respectively). It became apparent that the lower the oral intake function level at the initial examination, the higher the prevalence of reduced multidimensional functional status. Mental function was found to predict the effects of dysphagia rehabilitation in the maintenance stage.