Dysphagia in the Elderly: Preliminary Evidence of Prevalence, Risk Factors, and Socioemotional Effects

Dept of Communication Sciences and Disorders, The University of Utah, 390 South 1530 East, Room 1219, Salt Lake City, UT 84112-0252, USA.
The Annals of otology, rhinology, and laryngology (Impact Factor: 1.05). 12/2007; 116(11):858-65. DOI: 10.1177/000348940711601112
Source: PubMed

ABSTRACT Epidemiological studies of dysphagia in the elderly are rare. A non-treatment-seeking, elderly cohort was surveyed to provide preliminary evidence regarding the prevalence, risks, and socioemotional effects of swallowing disorders.
Using a prospective, cross-sectional survey design, we interviewed 117 seniors living independently in Utah and Kentucky (39 men and 78 women; mean age, 76.1 years; SD, 8.5 years; range, 65 to 94 years) regarding 4 primary areas related to swallowing disorders: lifetime and current prevalence, symptoms and signs, risk and protective factors, and socioemotional consequences.
The lifetime prevalence of a swallowing disorder was 38%, and 33% of the participants reported a current problem. Most seniors with dysphagia described a sudden onset with chronic problems that had persisted for at least 4 weeks. Stepwise logistic regression identified 3 primary symptoms uniquely associated with a history of swallowing disorders: taking a longer time to eat (odds ratio [OR], 9.5; 95% confidence interval [CI], 2.3 to 40.2); coughing, throat clearing, or choking before, during, or after eating (OR, 3.4; 95% CI, 1.1 to 10.2); and a sensation of food stuck in the throat (OR, 5.2; 95% CI, 1.8 to 10.0). Stroke (p = .02), esophageal reflux (p = .003), chronic obstructive pulmonary disease (p = .05), and chronic pain (p = .03) were medical conditions associated with a history of dysphagia. Furthermore, dysphagia produced numerous adverse socioemotional effects.
This study provides preliminary evidence to suggest that chronic swallowing disorders are common among the elderly, and highlights the need for larger epidemiological studies of these disorders.

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Available from: Nelson Roy, Mar 10, 2015
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    • "In the United States, it is estimated that about 300,000–600,000 persons each year experience dysphagia, as a result of stroke or other neurological disorders (Mann et al., 2000; Paciaroni et al., 2004) and that up to 6 million adults are at risk for it (Sura et al., 2012). Dysphagia affects up to 68% of elderly nursing home residents (Steele et al., 1997), 30% of the elderly admitted to the hospital (Lee et al., 1999), 64% of stroke patients (Mann et al., 2000), and 13–38% of elderly who live independently (Kawashima et al., 2004; Roy et al., 2007). "
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    ABSTRACT: Objective Neurogenic dysphagia (ND) is a prevalent condition that accounts for significant mortality and morbidity worldwide. Screening and follow-up is critical for early diagnosis and management which can mitigate its complications and be cost-saving. Aims of this study are to provide a comprehensive investigation of the dysphagia limit in a large diverse cohort and to provide a longitudinal assessment of dysphagia in in a subset of subjects. Methods We developed a quantitative and non-invasive method for objective assessment of dysphagia by using laryngeal sensor and submental electromyography. Dysphagia Limit (DL) is the volume at which second or more swallows become necessary to swallow the whole amount of bolus. This study represents 17 years experience with the DL approach in assessing ND in a cohort of 1,278 adult subjects consisting of 292 healthy controls, 784 patients with dysphagia and 202 patients without dysphagia. One hundred and ninety two of all patients were also re-evaluated longitudinally over a period of 1-19 months. Results DL has 92% sensitivity; 91% specificity; 94% positive predictive value and 88% negative predictive value with an accuracy of 0.92. Patients with ALS, stroke and movement disorders have the highest sensitivity (85-97%) and positive predictive value (90-99%). The clinical severity of dysphagia has significant negative correlation with DL (r=-0.67, p<0.0001). Conclusions We propose the DL as a reliable, quick, non-invasive, quantitative test to detect and follow both clinical and subclinical dysphagia and it can be performed in an EMG laboratory. Significance Our study provides specific quantitative features of DL test that can be readily utilized by the neurologic community and nominates DL as an objective and robust method to evaluate dysphagia in a wide range of neurologic conditions.
    Clinical Neurophysiology 07/2014; 126(3). DOI:10.1016/j.clinph.2014.06.035 · 2.98 Impact Factor
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    • "An estimated 18 million adults have dysphagia in the United States alone (ECRI, 1999), with increased prevalence in advancing age due to higher rates of dysphagia-inducing neurological damage or disorders such as stroke (Robbins et al., 1993), Alzheimer's disease (Priefer and Robbins, 1997), and Parkinson's disease (Robbins et al., 1986). Almost 40% of healthy, independent-living seniors have reported dysphagia in their lifetime (Roy et al., 2007). Within healthy aging, swallowing kinematics (i.e. "
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    NeuroImage 11/2008; 44(3):982-91. DOI:10.1016/j.neuroimage.2008.10.012 · 6.36 Impact Factor
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