Abstract
Objectives
Dysphagia is a frequent finding in nursing home residents. The aim of this study is
to evaluate the association of dysphagia and mortality in nursing home residents and
identify further risk factors for mortality in residents with dysphagia.
Design
One-day, annually repeated cross-sectional study, evaluating the nutritional situation
of nursing home residents with 6-month mortality as outcome.
Setting
191 nursing homes from 14 countries in Europe and the United States participating
in the nutritionDay study between 2007 and 2012.
Participants
Data of all nursing home residents in the nutritionDay study aged 65 years or older
with available information about dysphagia and outcome were analyzed.
Measurements
Residents’ characteristics and mortality rate were calculated by group comparison,
and mortality risk was calculated by multivariate regression analysis with adjustment
for potential confounding factors.
Results
10,185 residents (78% female) with a mean age of 85 ± 8.1 years were included in the
analysis. Dysphagia was reported in 15.4% of residents. The 6-month mortality of residents
with dysphagia was significantly higher than of those without dysphagia (24.7% vs
11.9%; P < .001). The multivariate regression analysis revealed dysphagia [odds ratio (OR)
1.44, 95% confidence interval (CI) 1.24-1.68, P < .001] along with body mass index <20 (OR 1.78, 95% CI 1.55-2.03, P < .001) and weight loss >5 kg (OR 1.61, 95% CI 1.37-1.88, P < .001) as independent and significant risk factors for mortality. Because of significant
interaction, a disproportionately high mortality of 38.9% was found in residents with
dysphagia accompanied by previous weight loss >5 kg (OR for interaction 1.44; 95%
CI 1.03-2.01; P = .032). Tube feeding was reported in 14.6% of residents with dysphagia. The mortality
rate of dysphagic residents receiving tube feeding vs those who were not was not significantly
different (21.4% vs 25.3%; P = .244).
Conclusion
In this nutritionDay study, dysphagia was identified as an independent risk factor
for mortality in nursing home residents. Residents with dysphagia accompanied by weight
loss are at a particularly high risk of mortality and should therefore receive special
attention.
Keywords
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Article info
Publication history
Published online: May 17, 2018
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Dysphagia in Frail Older Persons: Making the Most of Current KnowledgeJournal of the American Medical Directors AssociationVol. 19Issue 9
- PreviewDysphagia and related problems with oral intake must certainly be numbered among the important geriatric syndromes.1 They, like other geriatric syndromes, become increasingly common as people age, are especially prevalent in aging-related conditions such as stroke and Alzheimer's disease, and are usually multifactorial.2 In developing evidence-based approaches to such common aging problems, the scientific community goes through a sequence of investigative steps. We begin by identifying and defining the problem.
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