High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital

Popman, Amy; Richter, Marilize; Allen, Jacqueline; Wham, Carol

doi:10.1111/1747-0080.12385

Cited by 38 publications

(35 citation statements)

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“…However, to our knowledge, no study has previously investigated this relationship in a representative sample of European non-institutionalized older outpatients. Overall, previous findings support our results, and with the exception of Sakai and colleagues, the majority of studies focused on swallowing disturbances with malnutrition as a common sequela [29,30], or dysphagia as a prevalent risk factor for malnutrition [7,22,24,25,31]. We hypothesized dysphagia as the dependent variable, and malnutrition as one of the independent factors.…”

Section: Tablesupporting

confidence: 89%

The risk of dysphagia is associated with malnutrition and poor functional outcomes in a large population of outpatient older individuals

et al. 2019

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Oropharyngeal dysphagia (OD) is a widespread clinical condition among older adults. Although it represents a risk factor for malnutrition, dehydration and aspiration pneumonia, its assessment and contribution to functional decline is often ignored. The aim of the present study was to estimate the prevalence of OD in a large population of non-institutionalized older people and to evaluate its relationship with malnutrition and physical function. 10-item Eating Assessment Tool (EAT-10) and Mini Nutritional Assessment Short Form (MNA-SF) were used to identify the risk of dysphagia and malnutrition. Short Physical Performance Battery (SPPB) and hand-grip strength were used as functional endpoints. The relationship between risk of dysphagia and functional outcomes was tested in a multivariate regression analysis adjusted for age and sex (Model 1) and for other confounders including Mini Mental State Examination (MMSE) and polypharmacy (Model 2). Mean age of 773 subjects (61.3% female) was 81.97 years. The percentage of participants at risk of dysphagia (EAT ! 3) was 30.1%, 37.8% of subjects was malnourished (MNA-SF < 8), 46.2% was at risk of malnutrition (MNA-SF:8e11). EAT-10 was significantly and negatively associated to MNA-SF (b ¼ À0.47 ± 0.06, p < 0.0001) and the strength of the relationship was attenuated but still statistically significant in the multivariate model (b ¼ À0.28 ± 0.07, p < 0.0001). A significant and negative relationship was found between EAT-10 and SPPB and hand-grip strength in Model 1 (b ¼ À0.25 ± 0.05, p < 0.0001) and Model 2 (b ¼ À0.07 ± 0.03, p < 0.0001). After categorization of risk of dysphagia in two groups (at risk and not at risk), MNA-SF, SPPB and hand-grip strength were independently associated with higher risk of dysphagia (OR ¼ 0.91, 95%CI ¼ 0.83e0.99, p ¼ 0.03; OR ¼ 0.83, 95%CI ¼ 0.77e0.89, p < 0.0001; OR ¼ 0.96, 95%CI ¼ 0.92e0.99, p ¼ 0.02, respectively). In a large group of outpatient older individuals, we observed a significant negative association between risk of dysphagia and nutritional and physical performance, suggesting that the screening of OD, possibly supported by its assessment, should be implemented in the geriatric setting to potentially prevent the functional decline.

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Section: Tablesupporting

confidence: 89%

The risk of dysphagia is associated with malnutrition and poor functional outcomes in a large population of outpatient older individuals

et al. 2019

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“…This suggests that both malnutrition risk and malnutrition are present in older adults prior to hospital admission. This study is an extension of our pilot investigation that reported malnutrition risk prevalence in adults ( n = 88) of advanced age (85+ years), wherein a similar prevalence of malnutrition risk was observed [46]. Previously, malnutrition has been identified in New Zealand older adults ( n = 55) hospitalised for hip fracture; where 42% were found to have at least two indices of protein energy malnutrition as evidenced by low triceps skinfold thickness, reduced mid-upper arm circumference, and low serum pre-albumin [47].…”

Section: Discussionmentioning

confidence: 75%

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

et al. 2018

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BackgroundMalnutrition in patients admitted to hospital may have detrimental effects on recovery and healing. Malnutrition is preceded by a state of malnutrition risk, yet malnutrition risk is often not detected during admission. The aim of the current study was to investigate the magnitude and potential predictors of malnutrition risk in older adults, at hospital admission.MethodsA cross-sectional was study conducted in 234 older adults (age ≥ 65 or ≥ 55 for Māori or Pacific ethnicity) at admission to hospital in Auckland, New Zealand. Assessment of malnutrition risk status was performed using the Mini Nutritional Assessment Short-Form (MNA®-SF), dysphagia risk by the Eating Assessment Tool (EAT-10), muscle strength by hand grip strength and cognitive status by the Montreal Cognitive Assessment (MoCA) tool.ResultsAmong 234 participants, mean age 83.6 ± 7.6 years, 46.6% were identified as at malnutrition risk and 26.9% malnourished. After adjusting for age, gender and ethnicity, the study identified [prevalence ratio (95% confidence interval)] high dysphagia risk [EAT-10 score: 0.98 (0.97–0.99)], low body mass index [kg/m2: 1.02 (1.02–1.03)], low muscle strength [hand grip strength, kg: 1.01 (1.00–1.02)] and decline in cognition [MoCA score: 1.01 (1.00–1.02)] as significant predictors of malnutrition risk in older adults at hospital admission.ConclusionAmong older adults recently admitted to the hospital, almost three-quarters were malnourished or at malnutrition risk. As the majority (88%) of participants were admitted from the community, this illustrates the need for routine nutrition screening both at hospital admission and in community-dwelling older adults. Factors such as dysphagia, unintentional weight loss, decline in muscle strength, and poor cognition may indicate increased risk of malnutrition.

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“…This recommendation is supported by the findings of Popman, Richter, Allen, and Wham (2018), who described an association between a high risk of malnutrition and a higher prevalence of dysphagia. Screening for dysphagia may provide valuable information that allows healthcare staff to prepare appropriate nutritional interventions (Popman et al, 2018). Wakabayashi and Matsushima (2016) also recommended assessing the nutritional status of every patient with dysphagia.…”

Section: What Do These Findings Mean For Clinical Practice?mentioning

confidence: 99%

Dysphagia and factors associated with malnutrition risk: A 5‐year multicentre study

Blanař

Hoedl

Lohrmann

et al. 2019

Journal of Advanced Nursing

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Aims To describe the associations between dysphagia and malnutrition risk and to identify predictors for dysphagia in a group of persons at risk of malnutrition in hospitals and nursing homes. Design A secondary analysis of cross‐sectional data from the years 2012–2016. Methods The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool for Adults (MUST). The data were compared regarding malnutrition risk and dysphagia. Regression analyses were conducted to identify variables that were associated with the risk of malnutrition and dysphagia. Results Patients (N = 17,580) were included in the study sample. The prevalence of dysphagia was 6.6% and the prevalence of malnutrition risk was 18.9%. A multivariable logistic regression analysis resulted in the identification of dysphagia and cancer as variables with the highest odds ratios with regard to malnutrition risk. Patients with cancer, stroke or respiratory diseases represent a high‐risk group for the co‐occurrence of dysphagia and risk of malnutrition. Conclusions Screening for dysphagia should be carried out on patients at risk of malnutrition as an integral part of their admission to a healthcare institution and especially on the higher risk group of patients with cancer, a stroke or a respiratory disease. Impact What problem did the study address? This study identified the relationship between dysphagia and malnutrition risk and associated factors. What were the main findings? Dysphagia among patients in the research sample was associated with more than two times higher prevalence of the malnutrition risk. Where and on whom will the research have an impact? Thorough malnutrition risk and dysphagia screening lead to better nursing care.

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High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital

Cited by 38 publications

References 38 publications

The risk of dysphagia is associated with malnutrition and poor functional outcomes in a large population of outpatient older individuals

The risk of dysphagia is associated with malnutrition and poor functional outcomes in a large population of outpatient older individuals

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

Dysphagia and factors associated with malnutrition risk: A 5‐year multicentre study

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