Prevalence and Methods for Assessment of Oropharyngeal Dysphagia in Older Adults: A Systematic Review and Meta-Analysis

Abstract

Background: This systematic review and meta-analysis aimed to estimate the pooled prevalence of dysphagia in older adults, subgrouping by recruitment settings and varying dysphagia assessment methods. Methods: Five major databases were systematically searched through January 2022. A random-effects model for meta-analysis was conducted to obtain the pooled prevalence. Results: Prevalence of dysphagia in the community-dwelling elderly screened by water swallow test was 12.14% (95% CI: 6.48% to 19.25%, I2 = 0%), which was significantly lower than the combined prevalence of 30.52% (95% CI: 21.75% to 40.07%, I2 = 68%) assessed by Standardized Swallowing Assessment (SSA) and volume-viscosity swallow test (V−VST). The dysphagia prevalence among elderly nursing home residents evaluated by SSA was 58.69% (95% CI: 47.71% to 69.25%, I2 = 0%) and by the Gugging Swallowing Screen test (GUSS) test was 53.60% (95% CI: 41.20% to 65.79%, I2 = 0%). The prevalence of dysphagia in hospitalized older adults screened by the 10-item Eating Assessment Tool was 24.10% (95% CI: 16.64% to 32.44%, I2 = 0%), which was significantly lower than those assessed by V-VST or GUSS tests of 47.18% (95% CI: 38.30% to 56.14%, I2 = 0%). Conclusions: Dysphagia is prevalent in the elderly, affecting approximately one in three community-dwelling elderly, almost half of the geriatric patients, and even more than half of elderly nursing home residents. The use of non-validated screening tools to report dysphagia underestimates its actual prevalence.

Malnutrition in aged care: interplay between dysphagia and diet

“…In a recent substantial sample of European and Israeli nursing home residents (n ¼ 3451), dysphagia was observed in 30% of residents, with 14% of those with dysphagia experiencing unintentional weight loss [12 && ]. The prevalence of dysphagia in older adults was recently examined in a comprehensive systematic review by Doan et al [13], including 32…”

“…In a recent substantial sample of European and Israeli nursing home residents ( n = 3451), dysphagia was observed in 30% of residents, with 14% of those with dysphagia experiencing unintentional weight loss [12 ▪▪ ]. The prevalence of dysphagia in older adults was recently examined in a comprehensive systematic review by Doan et al [13], including 32 studies conducted between 2002 and 2021. Their meta-analysis revealed that nursing homes have the highest prevalence of dysphagia among all settings, with approximately 47% of residents diagnosed with dysphagia, ranging from 31 to 61% in nine studies [13].…”

“…The prevalence of dysphagia in older adults was recently examined in a comprehensive systematic review by Doan et al [13], including 32 studies conducted between 2002 and 2021. Their meta-analysis revealed that nursing homes have the highest prevalence of dysphagia among all settings, with approximately 47% of residents diagnosed with dysphagia, ranging from 31 to 61% in nine studies [13]. Variations in prevalence are potentially impacted by the diagnostic methods of identifying dysphagia.…”

Dysphagia and dementia: a ‘double dilemma’

“…In a recent large-scale systematic review and meta-analysis by Doan et al [15], screening tests for OPD in the elderly (>60 years) across community-dwelling, nursing home, and hospital settings were investigated. Screening tools represented in 32 studies meeting criteria for inclusion were the SSA (Standardized Swallowing Assessment), V-VST (Volume-Viscosity Swallow Test), GUSS (Guggin Swallowing Screen Test), and the EAT-10 (Eating Assessment Tool).…”

Cambios gastrointestinales en el envejecimiento: impacto sobre la alimentación y el estado nutricional.

“…44 (3) 396-414 • Julio -Septiembre 2022 La disfagia se considera más una consecuencia a diferentes patologías que al mismo proceso de envejecimiento. La prevalencia de disfagia en los adultos mayores puede variar entre 13 y 59 %, dependiendo del método de evaluación (21). Esta puede ocurrir en el adulto mayor, secundario a los accidentes cerebrovasculares, cirugías de cabeza y cuello y enfermedades neurológicas progresivas; puede ser de origen orofaríngeo o esofágico dependiendo de la enfermedad de base; y algunas pueden ser tratadas y reversibles (cuadro 1).…”