Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults at hospital admission

Chatindiara, Idah; Allen, Jacqueline; Popman, Amy; Patel, Darshan; Richter, Marilize; Kruger, Marlena; Wham, Carol

doi:10.1186/s12877-018-0771-x

Cited by 43 publications

(45 citation statements)

References 59 publications

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“…45,46 In our recently published study that assessed nutrition risk of older adults (mean age 84 years) at hospital admission, about 27% were identified as malnourished and 47% at risk of malnutrition. 47 Most (88%) participants were admitted from the same community (Auckland) as the current study, suggesting that prevalence of nutrition risk among community-dwelling older New Zealanders is especially high among those who are unwell. 47 Nutrition risk was less likely to occur among adults younger than 85 years when compared to those of advanced age, and the odds for nutrition risk increased with every yearly increase in participants' age.…”

Section: Discussionmentioning

confidence: 67%

“…47 Most (88%) participants were admitted from the same community (Auckland) as the current study, suggesting that prevalence of nutrition risk among community-dwelling older New Zealanders is especially high among those who are unwell. 47 Nutrition risk was less likely to occur among adults younger than 85 years when compared to those of advanced age, and the odds for nutrition risk increased with every yearly increase in participants' age. This finding agrees with previous studies that report a significant increase in community nutrition risk with advancing age.…”

Section: Discussionmentioning

confidence: 67%

“…In these studies of 225 Australian and 272 German participants, less than 1% were malnourished and 11–16% were at risk of malnutrition 45,46 . In our recently published study that assessed nutrition risk of older adults (mean age 84 years) at hospital admission, about 27% were identified as malnourished and 47% at risk of malnutrition 47 . Most (88%) participants were admitted from the same community (Auckland) as the current study, suggesting that prevalence of nutrition risk among community‐dwelling older New Zealanders is especially high among those who are unwell 47 …”

Section: Discussionmentioning

confidence: 99%

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Associations between nutrition risk status, body composition and physical performance among community‐dwelling older adults

Chatindiara

Williams

Sycamore

et al. 2019

Australian and New Zealand Journal of Public Health

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Objective: To investigate the associations between nutrition risk status, body composition and physical performance among community‐dwelling older New Zealanders. Methods: This cross‐sectional study enrolled 257 community‐dwelling older adults (median age 79 years). Assessments included the Mini Nutritional Assessment‐Short Form (MNA®‐SF) for nutrition risk; the Eating Assessment Tool‐10 for dysphagia risk; bioimpedance analysis for body composition (free fat mass (FFM) and percentage body fat) and gait speed for physical performance. A multiple logistics regression analysis was conducted, to determine factors associated with lower odds [OR (95% CI)] for nutrition risk. Results: Every yearly increase in age was associated with higher odds 1.09 (1.01–1.17) for nutrition risk. Additionally, nutrition risk was less likely to occur among participants of age <85 years 0.30 (0.11–0.79), with no dysphagia 0.29 (0.09–0.97) and those with a healthy gait speed 0.29 (0.09–0.97). Lower odds for nutrition risk were also found with increasing values of FFM index 0.51 (0.34–0.77), and percentage body fat 0.81 (0.72–0.90). Gait speed was positively correlated with FFM index (r=0.19 p<0.022), percentage body fat (r=0.23, p=0.006) and BMI (r=0.29, p<0.001). Conclusion: Among these participants, associations between nutrition risk, body composition and physical performance were found. Implications for public health: Routine screening of nutrition risk and/or physical performance among vulnerable older adults is key towards identifying those in need of assessment and dietary intervention. Alongside strategies to encourage physical activity, this may help to slow losses of FFM and protect physical performance.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Associations between nutrition risk status, body composition and physical performance among community‐dwelling older adults

Chatindiara

Williams

Sycamore

et al. 2019

Australian and New Zealand Journal of Public Health

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“…Of patients admitted to hospital, 3% of inpatients in the United States of America were diagnosed with dysphagia during their admission (Patel et al, 2018). This figure is much higher than the 0.35% figure reported from a sample taken from the National Hospital Discharge Survey within the United States of America between 2005(Altman et al, 2010.…”

Section: Prevalence Of Dysphagia In Acute Carementioning

confidence: 72%

“…Importantly though it is acknowledged that the 3% figure may still be a gross underestimation of the actual number of patients due to possible presence of subclinical dysphagia or errors in documentation and coding (Patel et al, 2018). In a large population study conducted within hospital services, the most common dysphagia related diagnoses on admission were fluid and electrolyte disorder, diseases of the oesophagus, stroke, and aspiration pneumonia (Altman et al, 2010).…”

Section: Prevalence Of Dysphagia In Acute Carementioning

confidence: 99%

Expanding speech pathology delegation practices: engaging Allied Health Assistants (AHAs) in dysphagia management in the acute hospital setting

Schwarz¹

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Speech Pathologists (SPs) are under increasing workforce pressures as a result of an ageing population and greater prevalence of chronic conditions. Considering this increasing workforce demand, within the context of limited health resources, workforce flexibility such as the consideration of task delegation is increasingly being encouraged within the literature and government policy. Though the use of delegation models within speech pathology has received some attention, particularly in the management of paediatric speech and language disorders, there is a paucity of evidence to support the use of delegation models in dysphagia management. This presents a significant gap, as dysphagia management is an integral part of the SP's role in the inpatient hospital setting and accounts for a significant proportion of workload demand in that context. Delegation of dysphagia related tasks to a trained Allied Health Assistant (AHA) offers a means to address increased workforce demand, while potentially improving workforce efficiency. Appropriate delegation of 'low value' tasks to another professional group may support the SP; to dedicate more time to high risk caseloads; increasing intensity of intervention; and contributing to quality and innovation initiatives. Hence the overall objective of this thesis was to generate new knowledge regarding the design, clinical implementation and evaluation of AHA delegation models in the clinical area of dysphagia management. Two specific aims were identified to achieve this. The first was to design, develop, implement and evaluate AHA delegation models for two key dysphagia related tasks, (mealtime observations and dysphagia screening), to establish accuracy and feasibility of task completion. The second aim was to evaluate I acknowledge that copyright of all material contained in my thesis resides with the copyright holder(s) of that material. Where appropriate I have obtained copyright permission from the copyright holder to reproduce material in this thesis and have sought permission from co-authors for any jointly authored works included in the thesis. v

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The Water Swallow Test and EAT‐10 as Screening Tools for Referral to Videofluoroscopy

Kuuskoski,

Vanhatalo,

Rekola

et al. 2023

The Laryngoscope

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BackgroundVideofluoroscopy (VFS) is the gold standard in evaluating dysphagia. Water swallow tests (WST) and the Eating Assessment Tool (EAT‐10) are commonly used in dysphagia screening. We aimed to determine the feasibility of WST and EAT‐10 as screening tools for referral to VFS.MethodsPatients (n = 150, median age: 70.0 years, range: 19–92 years, 58.7% female) referred to VFS completed the WST and EAT‐10 before the examination. In the WST, we evaluated both the qualitative parameters (coughing, possible change in voice) and quantitative parameters (average drinking bolus size, swallowing speed). Correlations of EAT‐10 total scores and WST parameters to the VFS findings were analyzed both individually and combined.ResultsIn the WST, the most specific (89.7%) predictor of normal VFS findings was the absence of coughing, and the most sensitive (79.1%) parameter to predict abnormal findings was a bolus size of ≤20 mL. Using a combination of coughing and a bolus size ≤20 mL (simplified WST), the sensitivity of predicting abnormal findings increased to 83.5%. The most sensitive (84.6%) predictor of penetration/aspiration was failing any parameter in the WST. Lack of coughing indicated an absence of penetration/aspiration with an 82.5% specificity. Swallowing speed or combining the EAT‐10 results with the WST results did not enhance the sensitivity or specificity of the WST for predicting the VFS results.ConclusionsCoughing and average drinking bolus size are the most important parameters in WST when screening for referral to VFS, whereas the swallowing speed does not seem to be useful. The WST is superior to EAT‐10 in predicting VFS findings.Level of Evidence4 Laryngoscope, 2023

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Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults at hospital admission

Cited by 43 publications

References 59 publications

Associations between nutrition risk status, body composition and physical performance among community‐dwelling older adults

Associations between nutrition risk status, body composition and physical performance among community‐dwelling older adults

Expanding speech pathology delegation practices: engaging Allied Health Assistants (AHAs) in dysphagia management in the acute hospital setting

The Water Swallow Test and EAT‐10 as Screening Tools for Referral to Videofluoroscopy

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