Subjective dysphagia in older care home residents: A cross-sectional, multi-centre point prevalence measurement

C.D. van der Maarel-Wierink, J.M.M. Meijers, L.M.J. de Visschere, C. de Baat, R.J.G. Halfens, J. Schols

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Dysphagia has been found to be strongly associated with aspiration pneumonia in frail older people. Aspiration pneumonia is causing high hospitalization rates, morbidity, and often death. Better insight in the prevalence of (subjective) dysphagia in frail older people may improve its early recognition and treatment.

Objective: First, to assess the prevalence of subjective dysphagia in care home residents in the Netherlands. Second, to assess the associations of subjective dysphagia with potential risk factors of dysphagia.

Design: Retrospective data-analysis of a cross-sectional, multi-centre point prevalence measurement.

Setting: 119 care homes in the Netherlands.

Participants: Data of 8119 care home residents aged 65 years or older were included and analyzed.

Methods: Subjective dysphagia was assessed by a resident's response to a dichotomous question with regard to experiencing swallowing problems. If a resident was not able to respond (e.g. residents with dementia or aphasia), the question was answered by the ward care provider, or the resident's file was consulted for registered swallowing complaints and/or dysphagia. Several residents' data were collected: gender, age, (number of) diseases, the presence of malnutrition, the Care Dependency Scale score, and the body mass index.

Results: Subjective dysphagia was found in 751 (9%) residents. A final model for subjective dysphagia after multivariate backward stepwise regression analysis revealed eight significant variables: age (B -0.022), Care Dependency Scale score (B -0.985), 'malnutrition' (OR 1.58; 95% CI 1.31-1.90), 'comorbidity' (OR 1.07; 95% CI 1.01-1.14), and the disease clusters 'dementia' (OR 0.55; 95% CI 0.45-0.66), 'nervous system disorder' (OR 1.55; 95% CI 1.20-1.99), 'cardiovascular disease' (OR 0.81; 95% CI 0.67-0.99) and 'cerebrovascular disease/hemiparesis' (OR 1.74; 95% CI 1.45-2.10).

Conclusion: It seems justified to conclude that subjective dysphagia is a relevant care problem in older care home residents in the Netherlands. Care Dependency Scale score, 'malnutrition', and the disease clusters 'dementia', 'nervous system disorder', and 'cerebrovascular disease/hemiparesis' were associated with the presence of subjective dysphagia in this study. Age, 'comorbidity' and 'cardiovascular disease' showed very small influence. 

Original languageEnglish
Pages (from-to)875-881
Number of pages7
JournalInternational Journal of Nursing Studies
Volume51
Issue number6
DOIs
Publication statusPublished - Jun 2014

Keywords

  • Nursing home
  • Cerebrovascular accident
  • Comorbidity
  • Dysphagia
  • Malnutrition
  • Swallowing disorders
  • DAILY ORAL CARE
  • OROPHARYNGEAL DYSPHAGIA
  • ASPIRATION PNEUMONIA
  • RISK-FACTORS
  • SWALLOWING DISORDERS
  • ALZHEIMERS-DISEASE
  • DEPENDENCY SCALE
  • NURSING-HOMES
  • STROKE
  • ADULTS

Cite this