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

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 l...

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Autores principales: Espinosa-Val, Mᵃ Carmen, Martín-Martínez, Alberto, Graupera, Mercè, Arias, Olivia, Elvira, Amparo, Cabré, Mateu, Palomera, Elisabet, Bolívar-Prados, Mireia, Clavé, Pere, Ortega, Omar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146553/
https://www.ncbi.nlm.nih.gov/pubmed/32213845
http://dx.doi.org/10.3390/nu12030863
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author Espinosa-Val, Mᵃ Carmen
Martín-Martínez, Alberto
Graupera, Mercè
Arias, Olivia
Elvira, Amparo
Cabré, Mateu
Palomera, Elisabet
Bolívar-Prados, Mireia
Clavé, Pere
Ortega, Omar
author_facet Espinosa-Val, Mᵃ Carmen
Martín-Martínez, Alberto
Graupera, Mercè
Arias, Olivia
Elvira, Amparo
Cabré, Mateu
Palomera, Elisabet
Bolívar-Prados, Mireia
Clavé, Pere
Ortega, Omar
author_sort Espinosa-Val, Mᵃ Carmen
collection PubMed
description 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.
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spelling pubmed-71465532020-04-20 Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia Espinosa-Val, Mᵃ Carmen Martín-Martínez, Alberto Graupera, Mercè Arias, Olivia Elvira, Amparo Cabré, Mateu Palomera, Elisabet Bolívar-Prados, Mireia Clavé, Pere Ortega, Omar Nutrients Article 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. MDPI 2020-03-24 /pmc/articles/PMC7146553/ /pubmed/32213845 http://dx.doi.org/10.3390/nu12030863 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Espinosa-Val, Mᵃ Carmen
Martín-Martínez, Alberto
Graupera, Mercè
Arias, Olivia
Elvira, Amparo
Cabré, Mateu
Palomera, Elisabet
Bolívar-Prados, Mireia
Clavé, Pere
Ortega, Omar
Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia
title Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia
title_full Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia
title_fullStr Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia
title_full_unstemmed Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia
title_short Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia
title_sort prevalence, risk factors, and complications of oropharyngeal dysphagia in older patients with dementia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146553/
https://www.ncbi.nlm.nih.gov/pubmed/32213845
http://dx.doi.org/10.3390/nu12030863
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