Oropharyngeal dysphagia in elderly inpatients in a unit of convalescence

Abstract

To describe the prevalence of oropharyngeal dysphagia at hospital discharge in elderly patients admitted to a Subacute Care Unit (SACU) using the Volume-Viscosity Swalow Test (V-VST) and an adapted version for severe dementia (V-VST-G). METHODOLOGY AND DESIGN: Descriptive cross-sectional study; duration; 50 days. Data gathered from the clinical chart at hospital discharge: demographical, clinical, risk factors, and complications of dysphagia, functional course, and V-VCAM and V-VCAM-G outcomes. The results are described comparing the data of the groups with and without dysphagia. 86 Patients (60% women), mean age 83.8 ± 6.7 years. The specific clinical history detected previous oropharyngeal dysphagia in 23 patients (26%). The V-VCAM detected oropharyngeal dysphagia in 46 patients (53.5%). Of them, 30 patients (65.21%) had mixed swallowing disorder, 15 (32.6%) had isolated efficacy disorder, and 1 (2.17%) had isolated safety disorder. Those patients with a positive dysphagia test had a statistically significant higher prevalence of cognitive disorder, higher age, and more positive history of previous dysphagia, worse functional course and mobility impairment, and more complications during their staying at the SACU. Dysphagia is highly prevalent among this group of elderly patients. Only half of the cases are diagnosed through the specific anamnesis. The V-VCAM detected a high prevalence of dysphagia so that its routine use is recommended specially in patients at risk taking into account the peculiarities of using it in the elderly. This at-risk population would be defined by characteristics such as higher age, cognitive and/or functional impairment.