The Prevalence of Dysphagia in Individuals Living in Residential Aged Care Facilities: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Information Sources
2.2. Study Selection
2.3. Data Extraction and Summary Measures
2.4. Quality Appraisal
2.5. Results Synthesis
3. Results
3.1. Participants
3.2. Assessment Tools Used
3.3. Who Completed the Assessment
3.4. Prevalence of Dysphagia
3.5. Quality Appraisal
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author, Year, Country | Study Type | Sample Size (n) | Age (Years) | Gender (% Male) | Prevalence of Dysphagia (n, %) | Tool for Dysphagia Assessment | Professional Who Conducted Dysphagia Assessment | Comments |
---|---|---|---|---|---|---|---|---|
Brochier et al., 2018, Brazil [59] | Prospective cross-sectional | 115 (3 long term care residences) | ≥60 Age range: 60–70 (19.1%) 71–80 (36.6%) ≥81 (44.3%) | 33% M | 70/115 (60.9%) In nervous system diseases: Not reported. In Dementia: Not reported. In Malnutrition: Not reported. In poor dentition: Not reported. | CSE | SLP | Higher xerostomia associated with oropharyngeal dysphagia (p < 0.001). Population able to provide informed consent. |
Feinberg et al., 1996, USA [64] | Prospective cohort | 152 (Single long-term care facility) | Mean age: 86 Age range: 78–96 | 36.8% M | 102/152 (67%) Oropharyngeal dysphagia: 81/102 (79%) Oesophageal dysphagia: 19/102 (18.6%) In nervous system diseases: Not reported. In dementia: Not reported. In malnutrition: Not reported. In poor dentition: Not reported. | VFSSCSE | CSE—SLP VFSS—Unclear, likely SLP | VFSS completed by 52/152 had 0% history of noted dysphagia (i.e., silent aspiration apparent). Method for gaining consent not reported. |
Hollaar et al., 2017 The Netherlands [60] | Retrospective cross-sectional | 373 (3 nursing homes) | ≥65 Mean age with dysphagia: 82.2 ± 9.1 Mean age without dysphagia: 83.5 ± 7.8 | 30.3% M | 59/373 (16%) In nervous system diseases: 18/59 (31%) In dementia: Not reported. In malnutrition: Not reported. In poor dentition: Not reported. | Data obtained from medical records. Original diagnostic tool: CSE upon admission, CSE after a cerebrovascular accident or in case of a history of cerebrovascular accident at the time of admission, CSE after reported clinical symptoms of or complaints about swallowing problems or previously registered signs and symptoms in the electronic medical file before admission. | SLP | Number of diagnostic methods completed by SLP unclear. Where dysphagia diagnosis was unclear, the SLP and elderly care physician were consulted for additional information. Method for gaining consent not reported. |
Langmore et al., 1998, USA [65] | Prospective cohort | 41 (Single nursing home care centre) | ≥60 | 100% M | 25/41 (61.6%) In nervous system diseases: Not reported. In dementia: Not reported. In malnutrition: Not reported. In poor dentition: Not reported. | CSE, VFSS, Scintigraphy examinations (~50% of subjects); Modified FEES (~50% of subjects). | Unclear—likely SLP | 81% of subjects with aspiration pneumonia had oropharyngeal dysphagia. Population able to provide informed consent. |
Pu et al., 2017, China [61] | Prospective cross-sectional | 584 (22 long term care facilities) | ≥ 60 Mean age: 84.5 ± 7.9 Mean age with dysphagia: 85 Mean age without dysphagia: 83.6 Age range: 56–105 Median age: 85 | Not reported. | 356/584 (61.1%) In nervous system diseases: Not reported. In dementia: Not reported. In malnutrition: Not reported. In poor dentition: Not reported. | CSE | SLP and trained research assistants including SLP students | Risk of dysphagia for total sample higher in those with pneumonia (OR 3.578 95% CI: 1.568–8.168, p = 0.002). Population able to provide informed consent. |
Rech et al., 2018 [62] (a) and Rech et al., 2018 [63] (b), Brazil | Prospective cross-sectional | 123 (exact number of long-term care facilities not reported, located in 3 separate towns) | ≥60 years Mean age: 73.5 ± 8.9 | 34.1% M | CSE: 75/123 (61%) EAT-10 tool: 25/123 (20.3%) DenSAT tool: 65/123 (52.8%) In nervous system diseases: Not reported. In dementia: Not reported. In malnutrition: Not reported. In those with partially functional dentition: 14/75 (18.7%). In those with Nonfunctional dentition: 55/75 (73.3%). | CSE, EAT-10 screening questionnaire; DenSAT assessment tool: Developed by 3 × SLP and conducted by dentists. Questionnaire—Subjective dysphagia. Oral motor and functionality assessment; Swallow assessment. | CSE—SLP DenSAT—Dentist | Dysphagia in those with ≥4 oral sensory motor alterations: 54/75 (72%). Only 27.6% reported difficulty swallowing (i.e., silent aspiration apparent). 47.3% of individuals with dysphagia also had a BMI <24.9 (underweight). Population able to provide informed consent. |
Sarabia-Cobo et al., 2016, Spain [66] | Prospective cohort | 2384 (12 nursing homes) | Mean age: 88.7 ± 6.8 Mean age with dysphagia: 89.4 ± 6.3 Age range: 69–101 | 26.6% | 1659/2384 (69.6%) In nervous system diseases: Not reported. In dementia: 1135/1659 (68.4%) In malnutrition: Not reported. In poor dentition: Not reported. | Data obtained from medical records. Original diagnostic tool: CSE. | Doctor | Positive correlation between the presence of neurological disease and dysphagia (rho = 0.56, p = 0.00), cognitive impairment and dysphagia (rho = 0.61, p = 0.01) and dysphagia and functional capacity (r = 0.65, p = 0.00). Method for gaining consent not reported. |
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Roberts, H.; Lambert, K.; Walton, K. The Prevalence of Dysphagia in Individuals Living in Residential Aged Care Facilities: A Systematic Review and Meta-Analysis. Healthcare 2024, 12, 649. https://doi.org/10.3390/healthcare12060649
Roberts H, Lambert K, Walton K. The Prevalence of Dysphagia in Individuals Living in Residential Aged Care Facilities: A Systematic Review and Meta-Analysis. Healthcare. 2024; 12(6):649. https://doi.org/10.3390/healthcare12060649
Chicago/Turabian StyleRoberts, Hollie, Kelly Lambert, and Karen Walton. 2024. "The Prevalence of Dysphagia in Individuals Living in Residential Aged Care Facilities: A Systematic Review and Meta-Analysis" Healthcare 12, no. 6: 649. https://doi.org/10.3390/healthcare12060649