Swallowing disturbances and psychiatric profile in older adults: The GreatAGE study

Introduction Several studies have reported controversial links between swallowing disturbances (SD) and psychiatric disorders in older age. The available data on the epidemiology of SD in the general population are scarce and often conflicting, because of numerous methodological factors source of possible counfounders. Objectives We aimed to screen the presence of psychiatric and cognitive disorders associated with SD in a random sampling of the general population ≥ 65. Methods A sample of 1127 elderly individuals collected in a population-based study (GreatAGE) in Castellana Grotte (53,50% males, mean age 74.1 ± 6.3 years), South-East Italy, were mailed a validated self-report questionnaire to assess SD (Eating Assessment Tool-EAT10). Psychiatric disorders and symptoms [assessed with Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, Geriatric Depression Scale-30 (GDS-30) and Symptom Checklist Revised-90 (SCL-90R)], cognitive functions were assessed with a comprehensive neuropsychological battery, neurological exam, and demographics were compared in participants with and without SD using t -tests and Mann–Whitney U -test. Results The prevalence rates of SD amounted at 5.97%. Psychiatric diagnosis (24.22% of the sample) was statistically significant associated with SD (EAT ≥ 3, P  = 0.038), and a trend was found for major depressive disorder and generalized anxiety disorder. Among SCL-90R domains, only anxiety showed a significant association with EAT ≥ 3 ( P  = 0.006). GDS-30 score was found to be higher in subjects with SD ( P  = 0.008). Cognitive functions did not differ between the two groups except for an increasing trend for Clinical Dementia Rating Scale in EAT ≥ 3 ( P  = 0.058). Conclusions These preliminary results showed an association between SD in older age and late-life major depression and anxiety disorders.