High prevalence of oropharyngeal dysphagia in acutely hospitalized patients aged 80 and older

Abstract Objectives Oropharyngeal dysphagia is a geriatric syndrome that is usually underdiagnosed in older patients. The aim of this study was to determine the prevalence and identify the main risk factors of dysphagia in the oldest old patients admitted to an acute geriatric unit. Design Observational prospective study. Setting and Participants Older patients admitted to an acute geriatric unit of a university hospital. Measures 329 patients (mean age 93.5 years old, range 81-106) were assessed for oropharyngeal dysphagia within 48 hours of hospital admission using the Volume-Viscosity Swallow Test. Demographic characteristics, geriatric assessment, geriatric syndromes, comorbidities, drug treatment, and complications were examined to determine their association with the presence of dysphagia. Results Oropharyngeal dysphagia was present in 271 (82.4%) of the participants. Multivariate logistic regression showed that malnutrition (OR 3.62, p=0.048, 95% CI 1.01-12.93), admission for respiratory infection (OR 2.89, p=0.004, 95% CI 1.40-5.94), delirium (OR 2.89, p=0.004, 95% CI 1.40-5.94), severe dependency (OR 3.23, p=0.017, 95% CI 1.23-8.87) and age (OR 1.11, p=0.03, 95% CI 1.01-1.21) were significantly associated with dysphagia. The use of a calcium antagonist at the time of admission was associated with a reduced risk of dysphagia (OR 0.39, p=0.03, 95% CI 0.16-0.92). Implications The prevalence of oropharyngeal dysphagia is high in the oldest old patients admitted to an acute geriatric unit when assessed with an objective diagnostic method. Our findings suggest that objective swallowing assessment should be routinely performed on admission, in order to start early interventions to avoid complications of dysphagia in this complex population.