Chewing Problems Research Articles

Epidemiological Determinants of Malnutrition Status among Geriatric Population Residing at High Altitude Region of Rural Uttarakhand, India

AbstractBackgroundHigh prevalence of Malnutrition exists amongst the geriatric population in India. Evidence on malnutrition is available from the plain regions of the country. However there is lack of scientific evidence on malnutrition status of geriatric population residing at high altitude regions of Uttarakhand, India.Materials and methodsA community based cross-sectional study was conducted during 2015–2016 in District Nainital. Thirty clusters were identified using population proportionate to size sampling method; 30 geriatric subjects were selected from each cluster. Study population included 980 geriatric aged 60 years and above. Nutritional status of the geriatric population was assessed using Mini Nutritional Assessment (MNA) tool. Standard procedures were used to determine the height, weight, MCC and MUAC. The BMI was calculated from the measurements of weight (kg) and height (cm) (kg/m2). Data was entered in MS Excel 2007 and analyzed using SPSS version 20.0.ResultsThe MNA revealed that only 22.4% geriatric subjects had satisfactory nutritional status, 14.3% were malnourished and 63.3% were “at risk” of malnutrition. High prevalence of malnutrition was found among subjects belonging to age group of 60–70 years (58.9%), illiterate (74.5%) with family monthly income (1866–5546;43.3%), financially dependent (75.2%), with loss of appetite (71.6%), with chewing problem (63.1%) and who consumed < 2 full meals daily. (73.1%; all p < 0.0001;) in comparison to the subjects who had satisfactory nutritional status.ConclusionsThe present findings revealed that the high prevalence of malnutrition amongst the geriatric population in India. The risk factors identified were financial dependency, dietary intake, loss of appetite and chewing problem. Interventions to decrease these risk factors possibly may lead to reduction in malnutrition among geriatric population.

Association between Diabetes and Chewing Problems and Periodontal Disease in Korean Adults

Association between Diabetes and Chewing Problems and Periodontal Disease in Korean Adults

Association between Chewing Problems and Sleep among Japanese Adults.

An association between physical illness and sleep has been suggested. Disordered chewing might be a physical factor that is associated with sleep issues. This cross-sectional study aimed to determine whether chewing problems are associated with sleep in Japanese adults. Sleep and chewing issues were evaluated in 6,025 community residents using a self-reported questionnaire. The prevalence of poor sleep quality and sleeping for <6 h/day (short duration) were 15.6% and 29.4%, respectively. Multivariate logistic regression analyses showed that prevalence of poor sleep quality was significantly associated with self-reported medical history (odds ratio (OR), 1.30; p < 0.001), self-reported symptoms (OR, 4.59; p < 0.001), chewing problems (OR, 1.65; p < 0.001), and poor glycemic control (OR, 1.43; p=0.035). The prevalence of short sleep duration was also significantly associated with female sex (OR, 1.23; p=0.001), self-reported symptoms (OR, 1.60; p < 0.001), chewing problems (OR, 1.30; p=0.001), and being overweight (OR, 1.41; p < 0.001). In conclusion, chewing problems were associated with poor sleep quality and short sleep duration among Japanese adults.

Cachexia and Cognitive Function in the Community-Dwelling Older Adults: Mediation Effects of Oral Health.

Cognitive impairment and poor oral health are common problems in older adults and are associated with malnutrition. However, it is unclear how they are related to cachexia in community-dwelling older adults. The aim of this study was to examine the relationships among cachexia, cognitive function, and oral health in community-dwelling older adults. This study is a secondary analysis of a data-set. Data were collected in the community setting on older adults who applied for government-funded long-term care services in Hong Kong in 2017. Subjects were community-dwelling and aged ≥60 years. The outcome variable was cachexia. The predictors were cognitive function and oral health. The covariates included demographics and comorbidities associated with cachexia or malnutrition. Path analysis was employed to examine the associations among cachexia, cognitive function, and oral health using the software SAS/STAT and Mplus. This analysis included 12,940 subjects. The prevalence of cachexia was 1.3%. Cognitive function was also found to have a direct effect on the oral health indicators of chewing problems (OR=1.073, p<0.001), brushing teeth problems (OR=1.349, p<0.001), and swallowing problems (coeff.=0.177, p<0.001). Oral health indicators with a direct effect on cachexia included dry mouth (OR=1.250, p<0.001), brushing teeth problems (OR = 1.185, p<0.01), and swallowing problems (OR=1.231, p<0.001). Cognitive function had no significant direct effect, but had a significant indirect effect on cachexia (OR=1.100, p<0.001) which is mediated by brushing teeth problems (OR=1.052, p<0.001) and swallowing problems (OR=1.038, p<0.001). Cognitive impairment causes cachexia indirectly through poor oral health. This study recommends adding cognitive function when screening community-dwelling older adults for cachexia. Health policymakers should stress regular oral health screening and interventions, and encourage increased utilization of oral health services by community-dwelling older adults with cognitive problems.

Oral Dysfunction in Patients With Head and Neck Cancer: A Systematic Review.

Head and neck cancers (HNCs) and their treatment may cause oral function impairment. This study was designed to identify oral dysfunction in patients receiving treatment for HNCs using a systematic review. The PubMed, Embase, and CINAHL databases were searched for studies on oral function impairment in patients receiving treatment for HNCs published between January 2014 and May 2019. Only descriptive, correlational, and interventional quantitative studies that included patients receiving treatment for HNCs who presented with oral dysfunction, were published in English during the aforementioned time frame, and were accessible in full-text versions were selected. Twenty-eight studies (13 cross-sectional, two longitudinal, 12 randomized controlled trial, and one retrospective chart review) fulfilled the inclusion criteria. Oral mucositis, dysphagia, xerostomia, trismus, and chewing and speech problems were the most common oral dysfunctions. Age, cancer stage, tumor location, treatment modalities, treatment status, treatment dose, and pretreatment oral function were factors associated with oral dysfunction. Although individual interventions were shown to improve oral dysfunction, the related evidence was inconclusive. Primary HNCs and their treatment significantly deteriorate oral function. A holistic and interdisciplinary approach may maximize oral function.

Unsafe Chewing: Choking and Other Risks

Unsafe Chewing: Choking and Other Risks

Burden of Oral Symptoms and Health-Related Quality of Life in Long-Term Care Settings in Helsinki, Finland.

Poor oral health may complicate eating and deteriorate nutritional status. However, little is known about how the burden of oral symptoms (OS) is associated with the health-related quality of life (HRQoL) of vulnerable older people in institutional settings. This study explores how the burden of certain OS (chewing problems, swallowing difficulties, dry mouth) is associated with functioning, morbidity, nutritional status and eating habits. It also examines the association between the OS burden and HRQoL. A cross-sectional study in 2017. All long-term care wards in Helsinki, Finland. 2401 older residents (74% females, mean age 83.9). Nurses assessed the residents and completed questionnaires on the participants' demographics, functional status, diagnoses, OS and eating habits. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and HRQoL with a 15-dimensional instrument (15D). Of the residents, 25.4% had one OS and 16.6% two or three OS. OS burden was associated linearly with poorer cognitive and physical functioning and a higher number of comorbidities, edentulousness without dentures, and less frequent teeth brushing/denture cleaning. OS burden was also associated with malnutrition, lower BMI and eating less during main meals. In the multivariate analyses adjusted for various confounding factors, a higher number of OS was associated with lower HRQoL. OS burden correlated with nearly all dimensions of HRQoL. Oral symptoms are associated with generic HRQoL. Therefore, OS should be regularly assessed and managed in daily care.

The Relationship Among Subjective Chewing Function, Chewing-Related Quality of Life, and Depression: A Structural Equation Modeling Approach

본 연구에서는 정상 노화 과정의 노인을 대상으로 주관적 씹기 기능, 씹기 관련 삶의 질-정서, 그리고 우울에 대해 조사하고, 변수 간 영향 관계에 대해 구조방정식 모형을 통해 검증하였다. 연구 대상자는 삼킴 평가 프로토콜(Swallowing Monitoring & Assessment Protocol, SMAP) 연구 참여자 중 일대일 설문을 통해 주관적 씹기 기능, 씹기 관련 삶의 질-정서, 노인우울척도(Geriatric Depression Scale, GDS) 평가를 모두 수행한 65세 이상 일반 노인 355명이었다. 연구결과, 노인들의 주관적 씹기 기능이 저하 될수록 씹기 관련 삶의 질이 저하되었다. 씹기 기능과 우울 사이에서 삶의 질은 부분 매개 역할을 하였으며 삶의 질의 저하에 따라 우울 지수도 증가하는 것으로 나타났다. 이 연구를 통해 씹기 문제는 ‘즐거움이 줄었다’, ‘우울하다’, ‘속상하다’, ‘스트레스를 받는다’, ‘사람들과의 모임을 꺼린다’와 같이 씹기 관련 정서에 영향을 미치고 이는 씹기 문제와 우울 간 관계에서 매개 역할을 하는 것으로 확인하였다. 이를 근거로 본 연구의 결과는 씹기 관련 삶의 질을 관리하고 우울을 최소화하는 방안을 마련하기 위한 기초 자료로 활용될 것을 기대한다.The purpose of this study was to clarify the relationship among subjective chewing function, chewing related quality-of-life-emotional, and depression among in the community-dwelling older adults. We utilized structural equation modeling (SEM) to analyze the effect among these variables. A total of 355 normal elderly completed the Swallowing Monitoring & Assessment Protocol (SMAP) and Geriatric Depression Scale (GDS). The results indicated that subjective chewing function was associated with quality of life-emotional, which was also related with depression. Additionally, in the path analysis, the quality-of-life-emotional partially mediates the path between subjective chewing function and depression. From the results, we confirmed that chewing problems could affect chewing related emotions such as ‘less pleasure’, ‘upset’, ‘depressed’, and ‘stressed’. It is also expected the results to be utilized as preliminary data to manage and to minimize on effect in the elderly who either present with chewing problems or are at risk for depression.

Association of Nutritional and Oral Health Status Amongst Geriatric Population in India (P01-005-19)

ObjectivesPoor oral health status has been suggested to negatively impact the food selection leading to malnutrition. There is lack of evidence on the association of oral health and nutritional status amongst elderly subjects in India. The present study was undertaken to assess the association of oral health and nutritional status amongst elderly subjects in India. MethodsA community based cross-sectional study was conducted during 2015–2016 in District Nainital, Uttarakhand state, India. A total of 1003 elderly population were enrolled from 30 clusters (villages) identified by using population proportionate to size sampling methodology. Information on socio demographic profile and anthropometric measurements was collected. Body mass index and Mini Nutritional Assessment (MNA) scale was calculated for assessment of nutritional status. A trained professional assessed the oral health status through physical examination. Dietary intake data were collected using 24 h dietary recall methodology. ResultsWe found that the prevalence of complete edentulism was 11%. Use of dentures was reported amongst only 9.6% subjects who were completely edentulous. Prevalence of underweight and malnutrition was significantly higher amongst subjects with complete loss of teeth, who were suffering with chewing problems and who did not wear dentures as compared to others.Subjects who wore dentures had significantly lower prevalence of malnutrition as compared to the subjects who did not wear dentures. The 24 hour dietary recall found that nutrient intake of macronutrients such as energy, protein, fat (all P < 0.05) and micronutrients such as calcium and riboflavin (all P < 0.01) were significantly higher in subjects who used rehabilitative measures through use of dentures as compared to those who did not wear dentures. ConclusionsWe found that the poor oral health status of the elderly subjects resulted in poor nutritional status amongst them. The present study will help the dentists in educating the elderly about the importance of maintaining adequate oral health status for achieving optimal nutritional and weight status. In addition, improvement in primary as well as rehabilitative dental care services and oralhealth care assess by the dentists will prove to be an effective measure in improving the nutritional status of the elderly. Funding SourcesNot Applicable.

Association between chewing problems and depression in Korean adults

Association between chewing problems and depression in Korean adults

Burden of Oral Symptoms and Its Associations With Nutrition, Well-Being, and Survival Among Nursing Home Residents

ObjectivesTo explore how oral problems, chewing problems, dry mouth, and swallowing difficulties cluster and whether their burden is associated with nutritional status, eating habits, gastrointestinal symptoms, psychological well-being, and mortality among institutionalized residents. DesignCross-sectional study with 1-year mortality. Setting and participants3123 residents living in assisted facilities and nursing homes in Helsinki, Finland. MeasuresTrained nurses assessed residents in all nursing homes and assisted living facilities in Helsinki in 2011. A personal interview, the Mini Nutritional Assessment (MNA), oral symptoms, questions about eating habits, and psychological well-being were used to assess each resident. We divided the subjects first according to the number of oral symptoms into 4 groups: no oral symptoms (G0), 1 oral symptom (G1), 2 oral symptoms (G2), and all 3 symptoms (G3); and second according to the symptoms: dry mouth, chewing problems, and swallowing difficulties. The diagnoses and medications were retrieved from medical records, and mortality data were obtained from central registers. ResultsIn all, 26% of the subjects had 1 oral problem (G1), 11% had 2 oral problems (G2), and 4% had all 3 oral problems (G3), whereas 60% (n = 1870) had no oral symptoms. Thus, the oral symptoms moderately overlapped. The burden of oral symptoms was linearly associated with malnutrition, higher numbers of comorbidities, dependency in physical functioning, gastrointestinal symptoms, and eating less and more often alone. The higher the burden of oral symptoms, the lower the self-rated health and psychological well-being. Mortality increased along with the higher oral symptoms burden. Among residents having 1 or more symptoms, 26% had chewing problems, 18% swallowing difficulties, and 15% dry mouth. Conclusions/ImplicationsThe burden of oral health problems was associated in a stepwise fashion with poor health and psychological well-being, malnutrition, and mortality. Clinicians should routinely assess older institutionalized residents' oral health status to improve residents’ well-being.

Dental status, visits, and functional ability and dietary intake of elderly in Israel

BackgroundEpidemiological studies have shown deterioration in dental health accompanying the ageing process. Tooth loss increases with age. Chewing ability is closely correlated with number of natural teeth present: there is a threshold of 20–21 teeth, below which chewing ability declines. The government of Israel is currently considering adding dental treatment for elderly to the basket of services of the National Health Insurance Law. Information on the influence of elderly’s dental health on nutrition and general health status can contribute to the decision making process.MethodsSecondary analysis of data collected on a subsample (N = 1776) of the cross-sectional Mabat Zahav - National Health and Nutrition Survey of the Elderly was done. Intakes of energy, fiber, protein, fruits and vegetables, associations with dental visits, dentures presence and functional ability were analyzed. Linear regression adjusted for confounders was performed.ResultsStatistically significant differences in dietary intake of energy, fiber, protein and vegetables were found between elderly who visited a dentist in the last year and those who did not. Elderly who possessed dentures had lower dietary intakes than their dentate counterparts. Elderly with functional problems such as impaired chewing had worse dietary intakes than the others. This was so after controlling for education, degree of interest in the relationship between nutrition and health and reading the nutrition label.ConclusionsThe findings in our study suggest that those who visited a dentist in the last year, had natural teeth and no denture/s and reported no chewing problems had better dietary intake. The results emphasize the importance of maintaining adequate dental health, preserving natural teeth and regular dental visits in the elderly to assure adequate nutrient status in this age group.

Effect of a functional variant of tumor necrosis factor-β gene in temporomandibular disorders: A pilot study.

Temporomandibular disorders (TMD) are a group of conditions that cause chronic orofacial pain. The tumor necrosis factor β (TNF-β) is a proinflammatory cytokine that is involved in the various aspects of the inflammatory process including organization and maintenance, and in the arrangement of cells at the inflammation site. The purpose of this study was to evaluate the correlation between TNF-β +252A/G (rs909253) variant and susceptibility to TMD in a Turkish cohort. The study included 104 patients (26 males, 78 females) with TMD and 126 healthy controls (44 males, 82 females). The TNF-β +252A/G variant analysis was based on Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). There was no deviation from HWA for TNF-β +252A/G variant in patient and control groups. There was significant difference in genotype and allele frequencies between patient group and control group in terms of TNF-β +252A/G variant, respectively (P=0.010, 0.015). A significant increase in the TNF-β +252 AG genotype and G allele frequencies were observed in TMD patients compared to healthy controls. The individuals with GG genotype and G allele had an increased risk of developing TMD. A statistically significant association was observed when the patients were compared with the controls according to AA genotype vs AG+GG genotypes (P=0.002, OR: 2.23, 95% CI:1.31-3.82). TNF-β +252A/G genotype distribution was associated with chewing problems (P=0.046). In conclusion, our results provided evidence that TNF-β +252A/G variant may contribute to TMD development in a Turkish cohort. Further studies are needed to confirm this observation.

Masticatory efficiency in patients with partially dentate dentitions

ObjectivesTo assess associations amongst masticatory performance, dental functional status, and perceived chewing problems with common soft and hard foods. Materials and methods387 adult participants with reduced natural dentitions were included and underwent an oral examination, completed a written structured questionnaire and performed a two-color chewing gum test for masticatory efficiency. A multivariate regression model was used to analyze associations between masticatory efficiency and a number of dental conditions, with age, gender and perceived chewing difficulties as background variables. Likelihood ratios were calculated to analyze the relationship between masticatory efficiency and dental conditions within a validated hierarchical dental functional classification system expressed by (1) number of teeth in upper and lower jaw, (2) completeness of anterior regions, (3) number of premolar occluding pairs, and (4) number of molar occluding pairs. ResultsThe regression model showed a significant positive association between unmixed ratio and self-reported problems with chewing (p = .004), and age (p < 0.001), and negative associations with having a sufficient premolar region (p < 0.001). In the hierarchical dental functional classification system, the likelihoods of having a high unmixed ratio and chewing problems with hard foods were highest for the predictor ‘less than 10 teeth in each jaw’ (LRs 4.01, respectively 13.06). ConclusionsIn partially dentates people, perceived chewing difficulties were associated with lower objective masticatory efficiency. Having fewer than 10 teeth in each jaw and having an impaired premolar region were best predictors for low masticatory efficiency. Clinical significanceThis study shows that having fewer than 10 teeth in each jaw and having an impaired premolar region are associated with low masticatory efficiency and chewing problems. Preservation of at least 10 teeth in each jaw and 3 to 4 premolars is important for preventing chewing difficulties.

The relationship between masticatory ability, age, and dental and prosthodontic status in an institutionalized elderly dentate population in Qingdao, China

ObjectivesTo identify relationships between masticatory ability and age, and dental and prosthodontic status amongst an institutionalized elderly dentate population in China.Materials and methodsA sample of 512 elders living in eight nursing homes in Qingdao was categorized based on a hierarchical dental functional classification system with and without tooth replacements. Masticatory disability scores (MDSs) were analyzed using multiple regression models with only age, and age and dentition variables for participants having ≥ 10 natural and those having < 10 natural teeth in each jaw.ResultsOverall, associations between MDS and age, number of teeth, and number of teeth replaced by dental prostheses were identified. For participants having ≥ 10 natural teeth in each jaw, no significant associations between MDS and age and dental and prosthodontic status were found. Participants having < 10 natural teeth in each jaw had higher MDS (increasing chewing difficulties) at higher ages. However, when “premolar region sufficient” and “molar region sufficient” were included, MDS was not associated with age, but with these dentition variables. For participants having ≥ 10 teeth including prosthodontically replaced teeth in each jaw, age was the only variable associated with MDS. For participants having < 10 teeth including teeth replaced in each jaw, the significant factor was “premolar region sufficient.” Overall, lower MDS was associated with increasing number of teeth, as well as with increasing number of teeth replaced by dental prostheses.ConclusionsIn this population of institutionalized dentate elderly, masticatory ability was significantly associated with dental and prosthodontic status.Clinical relevanceFor institutionalized elderly, having less than ten natural teeth in each jaw is associated with chewing problems. Most important dentition factor is the presence of three to four premolar pairs. Teeth added by partial removable dental prostheses compensate impaired masticatory ability due to tooth loss for 50% compared to natural teeth.

Synergy Extraction of Jaw Muscles During Mastication Based on Principal Components Analysis of Electromyogram Signal

Disorder in chewing food is a major problem in patients with stroke, some of those who suffer from brain lesion, multiple sclerosis, and other diseases such as head and neck cancer. This kind of disorder causes significantly decreased food consumption and consequently malnutrition or dehydration and in severe cases leads to suffocation. It can also increase the rate of death during the first year after the stroke to 45%. Therefore, finding an appropriate and common pattern of cooperation of jaw muscles in the act of chewing can have a very important role in assisting the process of rehabilitation in these patients. In this article, to improve current rehabilitation techniques for patients with chewing problems, attempts have been made to investigate the physiology of human chewing and involved muscles in this process. Extracting synergy patterns of jaw muscles during chewing action was also carried out in this article using analysis of the main components of electromyogram signal and quantification of muscle activity. The results show that each individual applies the same motion during different times for chewing action. Moreover, cooperation and interaction of the involved muscles are maintained in this process during various times in which the share of masseter muscle is more than temporal one in this collaboration.

Functional determinants of dietary intake in community-dwelling older adults: a DEDIPAC (DEterminants of DIet and Physical ACtivity) systematic literature review.

The identification of determinants of dietary intake is an important prerequisite for the development of interventions to improve diet. The present systematic literature review aimed to compile the current knowledge on individual functional determinants of dietary intake in community-dwelling older adults. A systematic search was performed in PubMed, Scopus, Web of Science and the Cochrane Library. Titles, abstracts and full texts were screened according to predefined inclusion and exclusion criteria. Studies were included when focusing on dietary intake as an outcome and on chemosensory, oral, cognitive or physical function as a determinant. Community. Older adults at least 65 years old without acute or specific chronic diseases. From initially 14 585 potentially relevant papers, thirty-six were included. For chemosensory, cognitive and physical function only a few papers were found, which reported inconsistent results regarding the relationship to dietary intake. In contrast, oral function was extensively studied (n 31). Different surrogates of oral function like dental status, number of teeth, bite force or chewing problems were associated with food as well as nutrient intakes including fibre. As all except six studies had a cross-sectional design, no causal relationships could be derived. Among functional determinants of dietary intake oral factors are well documented in older adults, whereas the role of other functional determinants remains unclear and needs further systematic research.

Oral Health of Parkinson's Disease Patients: A Case-Control Study.

The aim of the study was to examine the oral health status of Parkinson's disease (PD) patients, to compare their oral health status to that of a control group, and to relate it to the duration and severity of PD. Materials and Methods. 74 PD patients and 74 controls were interviewed and orally examined. Among PD patients, the duration and the Hoehn and Yahr stage (HY) of the disease were registered. Results. More PD patients than controls reported oral hygiene care support as well as chewing/biting problems, taste disturbance, tooth mobility, and xerostomia, whereas dentate patients had more teeth with carious lesions, tooth root remnants, and biofilm. Both longer duration and higher HY were associated with more chewing problems and, in dentates, more teeth with restorations. In dentates, longer duration of the disease was associated with higher number of mobile teeth. Higher HY was associated with more oral hygiene care support as well as biting problems and, in dentates, more teeth with carious lesions and tooth root remnants. Conclusions. Comparatively, PD patients had weakened oral health status and reduced oral hygiene care. Both duration and severity of the disease were associated with more oral health and hygiene care problems.

Orthognatic Surgery And Treatment: An Islamic Legal Maxims Analysis

Introduction: The position of facial bones contribute great impact to the shape of the face. Shape of these underlying facial bones responsible for a person facial proportions, angles and contours. Facial deformity can either be congenital or acquired. Functional impairment related to facial deformity include chewing problems, breathing problems, speech impairments and temporomandibular joint pathology. Orthognathic surgery is a procedure involving incision and manipulation using instrument to align the jaws. Performing cosmetic surgery seems to change the creation of Allah and the original law of changing Allah creation is prohibited. Materials and Methods: The approach use in this study is based on analysis of Quran, Sunnah, views of ulama and contemporary fatwas. Results: In assessing the orthognathic surgery law for patients with this dentofacial defect, the researcher found that the main issues that need to be investigated are the difficulties existed (Masyaqqah) and the level of patient harm in addition to the intention or purpose of performing orthognathic surgery. However, according to the principles of the Islamic jurisprudence, orthognathic surgery is permitted based on the principles such as ad-darar yuzal, almusyaqqah tajlibu al-taisir, al-darurat tuqaddiru biqadaruha, Irtikab Akhaf Al-Dhararain and aldarurat tubihu mahzurat serta al-Umur bimaqasidiha. Conclusion(s): Orthognathic surgery is permissable because the purpose is not to alter the original look but as measurement to treat defects and to restore function. This objective is very consistent with the fiqh rules that stated, every harm and distress should be eliminated.

Dysphagia in Nursing Homes—Results From the NutritionDay Project

ObjectivesDysphagia is a major healthcare problem as it increases the risk of malnutrition, dehydration, aspiration pneumonia, and death. The aims of this analysis of data from nursing homes (NHs) worldwide were to examine prevalence rates of dysphagia, to identify characteristics of residents with dysphagia, and to describe which type of nutrition residents with dysphagia receive. DesignOne-day cross-sectional study, repeated in yearly intervals since 2007. Setting926 NH units from 19 countries. ParticipantsNH residents participating in the nutritionDay between 2007 and 2014, aged 65 years or older, from Europe and North America, and with available information on dysphagia. MeasurementsData on resident and unit level were collected on nutritionDay by local nursing staff using standardized questionnaires. Residents' nutritional status, nutritional intake, general residents’ characteristics, and unit characteristics were of interest as potential predictors of dysphagia (no vs yes). Univariable generalized estimating equations were performed for all variables, and significant predictors (P < .01) included in a multivariable analysis. Nutritional strategies (type of diet, use of oral nutritional supplements, tube feeding, and parenteral nutrition) are described for residents with and without dysphagia. ResultsDysphagia was reported in 13.4% of the 23,549 residents included, with great variation in the prevalence rates between participating countries. Twelve variables of 23 remained in the multivariable model [area under the receiver operating curve = 0.898; 95% confidence interval (CI) 0.892–0.904; P < .001]. Residents who were not able to eat lunch orally on nutritionDay were 14.90 [odds ratio (OR); 95% CI 9.61–23.11] times more likely to have dysphagia compared with residents who ate everything. ORs of dysphagia were higher for residents with chewing problems (OR 10.48; 95% CI 8.98–12.23), immobile (OR 5.10, 95% CI 4.25–6.11) and partially mobile residents (OR 1.94; 95% CI 1.64–2.29) compared to mobile residents, and residents with severe cognitive impairment (OR 1.99; 95% CI 1.64–2.42). Poor nutritional status, digestive diseases, neurologic diseases, dehydration, and use of antibiotics were also related to a higher risk of dysphagia. The most common nutritional strategy for residents with dysphagia was providing texture-modified diet (42.5%) followed by normal diet (28.2%). One-quarter of residents with dysphagia received oral nutritional supplements additionally, 7.4% of residents with dysphagia received tube feeding exclusively, and 8.0% in combination with oral nutrition. ConclusionsThis analysis of NHs participating in the nutritionDay provides important insight into the current awareness of dysphagia, associated factors, and nutritional strategies. Residents who were unable to eat orally, malnourished, or dehydrated suffered more often from dysphagia, which substantiates the challenges of providing safe and adequate nutrition for residents with dysphagia. Adequacy and efficiency of different nutritional strategies need to be clarified in future studies.