Oropharyngeal dysphagia and nutritional status in elderly patients in the chronic post-stroke phases

Abstract

Cerebrovascular accident is the most common disorder in the older adult population and can impair the swallowing function, resulting in neurogenic dysphagia with greater occurrence in its acute phase. This study aimed to check how the oropharyngeal dysphagia degree impacts the oral intake and nutritional status of older adults affected by cerebrovascular accident in the late stage after stroke. This is a retrospective cross-sectional study. According to the Dysphagia Outcome and Severity Scale (DOSS), three judges classified the oropharyngeal dysphagia after analyzing the instrumental evaluation of swallowing images captured through fiberoptic endoscopic evaluation of swallowing (FEES). The level of oral intake classification (FOIS) was performed by reviewing the usual patterns of food intake reported in the 24-hour food recall, and the nutritional status assessment was performed using data from the Mini Nutritional Assessment (MNA®) and anthropometric measurements: weight, height, body mass index (BMI), circumferences (arm), skin folds (triceps; biceps; subscapular; suprailiac). Researchers included 25 older adult subjects (14 male and 11 female) with an average age of 72 years old. A positive correlation was found between the oropharyngeal dysphagia degree and FOIS (p=0.051), screening score (p=0.011), and total score (p=0.006) of the MNA® protocol, as well as between the classification of FOIS levels with the BMI (p=0.029) and anthropometric measurements referring to muscle mass – AC (p=0.021), AMC (p=0.010) and AMA (p=0.023). That leads to the conclusion that, although most research individuals had functional swallowing or mild dysphagia, their dysphagia influenced their level of oral intake and nutritional status.