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.
One-day, annually repeated cross-sectional study, evaluating the nutritional situation of nursing home residents with 6-month mortality as outcome.
191 nursing homes from 14 countries in Europe and the United States participating in the nutritionDay study between 2007 and 2012.
Data of all nursing home residents in the nutritionDay study aged 65 years or older with available information about dysphagia and outcome were analyzed.
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.
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).
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.
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Published online: May 17, 2018
The authors declare no conflicts of interest.
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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- 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.