Clinical and scintigraphic assessment of swallowing of older patients admitted to a tertiary care geriatric ward

Abstract

This study aimed to verify if older patients admitted to a tertiary care geriatric ward with no spontaneous complaints of dysphagia have impaired swallowing function as detected by a specialized clinical assessment and a scintigraphic study of swallowing. Thirty patients (mean age = 76.2 years, 17 women), consecutively admitted for the treatment of acute or chronic diseases, were studied. Two control groups were also studied, one consisting of 10 healthy older persons (mean age = 69.6 years, 5 women) and the other consisting of 20 young volunteers (mean age = 25.4 years, 11 women). A complete clinical assessment of swallowing was performed by a speech pathologist. Each subject was also submitted to scintigraphic studies of oropharyngeal transit after swallowing liquid and syrup boluses labeled with 99m technetium phytate. Transit time, clearance time, and residuals were measured. Five patients had impairments in swallowing function detected by clinical assessment, three of them in the absence of complaints even after specific questioning. Scintigraphic transit times did not differ between the groups studied; however, residuals after syrup swallows were greater in the patient group compared with the healthy older volunteers. These findings suggest an increased risk for aspiration and the usefulness of a brief assessment of swallowing function in all patients admitted to tertiary care geriatric wards.