Complications of Oropharyngeal Dysphagia: Malnutrition and Aspiration Pneumonia

The prevalence of oropharyngeal functional dysphagia among older people and neurological patients is very high and and can cause two important types of complications in these patients: (a) a decrease in the efficacy of deglutition leading to malnutrition and dehydration, (b) a decrease in deglutition safety, leading to tracheobronchial aspiration which results in aspiration pneumonia and can lead to death. Clinical screening methods should be used to identify patients with oropharyngeal dysphagia in order to identify those patients who are at risk of aspiration or malnutrition, videofluoroscopy (VFS) being the gold standard. Their study must be completed with a nutritional assessment to determine the risk of malnutrition and the status of hydration. Treatment with dietetic changes in bolus volume and viscosity, as well as rehabilitation procedures can improve deglutition and prevent nutritional and respiratory complications in these patients. Therefore, diagnosis and management of oropharyngeal dysphagia needs a multidisciplinary approach.