Sarcopenic Dysphagia Is Associated With Mortality in Institutionalized Older Adults.

Abstract

To estimate mortality associated with sarcopenic dysphagia. A 3-year follow-up cohort. Ninety-five nursing home residents were evaluated to determine the baseline presence or absence of oropharyngeal dysphagia and followed up for 3years. The primary outcome was the risk of death. Dysphagia was assessed using a volume-viscosity swallow test. We used an algorithm to determine sarcopenic dysphagia based on grip strength, walking speed, calf circumference, and exclusion of neurologic or structural causes of dysphagia. We constructed 3 subgroups: without dysphagia, nonsarcopenic dysphagia, and sarcopenic dysphagia. Cox proportional regression analyses were used to predict the risk of death. Thirty-five percent of participants had no dysphagia, 20% nonsarcopenic dysphagia, and 45% sarcopenic dysphagia. Sarcopenic dysphagia was independently associated with a higher risk of death [hazard ratio (HR) 2.44, 95% CI 1.02-5.80, P= .043] than without dysphagia. In addition, a higher Charlson Comorbidity Index score was associated with a higher risk of death (HR 1.33, 95% CI 1.01-1.75, P= .040). This study shows that sarcopenic dysphagia was associated with increased mortality among institutionalized older adults. These deaths could be potentially preventable.