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. 2020 Mar 24;12(3):863.
doi: 10.3390/nu12030863.

Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia

Mᵃ Carmen Espinosa-Val  1 , Alberto Martín-Martínez  2   3 , Mercè Graupera  1 , Olivia Arias  1 , Amparo Elvira  1 , Mateu Cabré  4 , Elisabet Palomera  5 , Mireia Bolívar-Prados  2   3 , Pere Clavé  2   3 , Omar Ortega  2   3
Affiliations

Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia

Mᵃ Carmen Espinosa-Val et al. Nutrients. .

Abstract

The prevalence of older patients with dementia and oropharyngeal dysphagia (OD) is rising and management is poor. Our aim was to assess the prevalence, risk factors, and long-term nutritional and respiratory complications during follow-up of OD in older demented patients. We designed a prospective longitudinal quasi-experimental study with 255 patients with dementia. OD was assessed with the Volume-Viscosity Swallowing Test and a geriatric evaluation was performed. OD patients received compensatory treatments based on fluid viscosity and texture modified foods and oral hygiene, and were followed up for 18 months after discharge. Mean age was 83.5 ± 8.0 years and Alzheimer's disease was the main cause of dementia (52.9%). The prevalence of OD was 85.9%. Up to 82.7% patients with OD required fluid thickening and 93.6% texture modification, with poor compliance. OD patients were older (p < 0.007), had worse functionality (p < 0.0001), poorer nutritional status (p = 0.014), and higher severity of dementia (p < 0.001) than those without OD and showed higher rates of respiratory infections (p = 0.011) and mortality (p = 0.0002) after 18 months follow-up. These results show that OD is very prevalent among patients with dementia and is associated with impaired functionality, malnutrition, respiratory infections, and increased mortality. New nutritional strategies should be developed to increase the compliance and therapeutic effects for this growing population of dysphagic patients.

Keywords: alzheimer disease; dementia; elderly; follow-up; mortality; respiratory infections; swallowing disorders.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prevalence of patients with impaired signs of efficacy and safety according to the different levels of viscosity included in the Volume-Viscosity Swallowing Test (V-VST). * p < 0.05; ** p < 0.01; *** p < 0.001; **** p < 0.0001 vs. liquid.
Figure 2
Figure 2
Eighteen-month survival curves for dysphagic and non-dysphagic patients. OD: oropharyngeal dysphagia patients; ND: patients without OD.
See this image and copyright information in PMC

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