Study on Factors Influencing Dysphagia in Elderly Patients with Chronic Obstructive Pulmonary Disease Based on Structural Equation Modeling

Abstract

Dysphagia can occur in elderly patients with chronic obstructive pulmonary disease due to poor coordination between breathing and swallowing. Dysphagia can not only lead to aspiration pneumonia and acute exacerbation of chronic obstructive pulmonary disease, but also increase the risk of death. Previous studies only analyzed the influencing factors, but did not explore the interaction and size of the influencing factors, and there is still a lack of epidemiological investigation of dysphagia in chronic obstructive pulmonary disease patients in China. This study investigated the current situation of dysphagia in patients with chronic obstructive pulmonary disease in elderly chronic obstructive pulmonary disease patients in China, and used structural equation model to explore the direct and indirect effects of influencing factors. From April 2019 to April 2020, 1020 elderly chronic obstructive pulmonary disease patients who met the inclusion and exclusion criteria in the department of respiratory Medicine in 9 tertiary hospitals in Ningxia were selected as study subjects. The data were collected through questionnaires, including general information, chronic obstructive pulmonary disease Assessment Test, Activities of Daily Living, Geriatric Depression Scale, The Mini Nutritional Assessment-Short Form, FRAIL assessment scale, and Water Swallowing Test. On the basis of exploratory factor analysis, Amos was used to construct the initial model in combination with literature and professional knowledge, and the overall fitting evaluation and modification of the model were carried out to construct the final model. The incidence of Dysphagia in patients with chronic obstructive pulmonary disease in elderly chronic obstructive pulmonary disease patients was 19.71 %. The modified structural equation model fitted well, and the comprehensive condition of the elderly, smoking condition and comorbidities directly affects the dysphagia (the effect values respectively were 0.372, 0.112 and 0.095).The disease condition not only directly affects dysphagia, but also influences it through the comprehensive condition of the elderly (direct effect 0.109, indirect effect 0.109, total effect 0.218); age factors not only directly affects dysphagia, but also influences it through The disease condition and comprehensive condition of the elderly (direct effect 0.113, indirect effect 0.183 and total effect 0.296). eating condition not only directly affects dysphagia, but also influences it through comprehensive condition of the elderly (direct effect 0.127, indirect effect 0.074, total effect 0.201). The comprehensive condition of the elderly, smoking status and comorbidities directly affects the swallowing function, and the effect value of comprehensive condition of the elderly on swallowing function is 0.372. The disease status, age factors and eating status not only directly affect swallowing function, but also indirectly affect it through other factors.