Meta-analysis of Dysphagia and Aspiration Pneumonia in Frail Elders

C.D. van der Maarel-Wierink, Jackie N. O. Vanobbergen, Ewald M. Bronkhorst, J. M. G. A. Schols, C. de Baat*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


As part of a systematic literature review, a comprehensive literature search was carried out to identify risk factors for aspiration pneumonia in frail older people. A prominent risk factor found was dysphagia with evidence level 2a, according to the Oxford Centre for Evidence-based Medicine Levels of Evidence. Subsequently, a meta-analysis of 4 cohort, 1 case-cohort, and 1 case-control study on dysphagia as a risk factor of aspiration pneumonia in frail older people was performed. Using a random effects model, we found a positive correlation between dysphagia and aspiration pneumonia: OR = 9.84; 95% CI = 4.15 - 23.33 (test for statistical homogeneity: p <0.001). Then, a subgroup meta-analysis was performed with 4 cohort studies, all including patients with a cerebrovascular disease. Once again, a positive correlation was found between dysphagia and aspiration pneumonia: OR = 12.93; 95% CI = 8.61 - 19.44. The test for statistical homogeneity revealed no statistically significant result (p = 0.15). It was concluded that dysphagia is a serious risk factor for aspiration pneumonia in frail older people, particularly in those suffering from a cerebrovascular disease.
Original languageEnglish
Pages (from-to)1398-1404
JournalJournal of Dental Research
Issue number12
Publication statusPublished - Dec 2011


  • dysphagia
  • gerontology
  • oral-systemic disease(s)
  • oral hygiene
  • risk factor(s)
  • swallowing

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