Dysphagia in Dementia: Influence of Dementia Severity and Food Texture on the Prevalence of Aspiration and Latency to Swallow in Hospitalized Geriatric Patients

Abstract

Objectives: To evaluate influences of disease severity and food texture on prevalence and type of dysphagia in hospitalized geriatric patients.

Design: We screened for dysphagia in 161 geriatric inpatients with different forms of dementia and 30 control patients.

Measurements: Signs of aspiration were registered with 3 different food consistencies (water, apple puree, and slice of an apple) and the latency until the first swallow was documented.

Setting: Geriatric department of an academic teaching hospital in Hamburg, Germany.

Results: Compared with the controls, patients with dementia more often showed signs of aspiration. In the patients with dementia, signs of aspiration occurred more frequently with water (35.6%) than with a slice of an apple (15.1%) or apple puree (6.3%). We observed an inverse relationship between Mini-Mental State Examination score level and the suspected rate of aspiration, as well as with the length of latency until the first swallow of puree.

Conclusions: The prevalence of dysphagia is high in patients with dementia, especially in patients with moderate to severe cognitive impairment. The relationships observed in this study encourage screening for dysphagia and adapting meal consistencies to prevent aspiration in patients with dementia.

Keywords: Dementia; aspiration pneumonia; dysphagia; nutrition.