Dysphagia in the Elderly: Preliminary Evidence of Prevalence, Risk Factors, and Socioemotional Effects

TLDR

Epidemiological studies of dysphagia in older adults are scarce. The study surveyed a non‑treatment‑seeking cohort of elderly individuals to estimate the prevalence, risk factors, and socioemotional impacts of swallowing disorders. A prospective cross‑sectional survey of 117 independent seniors in Utah and Kentucky collected data on lifetime and current prevalence, symptoms, risk factors, and socioemotional consequences of dysphagia. Among participants, 38 % reported a lifetime swallowing disorder and 33 % a current problem, with sudden onset and chronic persistence; key symptoms were prolonged eating, coughing/choking, and food‑stuck sensation, and risk factors included stroke, reflux, COPD, and chronic pain, while dysphagia also caused significant socioemotional distress.

Abstract

Objectives: Epidemiological studies of dysphagia in the elderly are rare. A non-treatment-seeking, elderly cohort was surveyed to provide preliminary evidence regarding the prevalence, risks, and socioemotional effects of swallowing disorders. Methods: Using a prospective, cross-sectional survey design, we interviewed 117 seniors living independently in Utah and Kentucky (39 men and 78 women; mean age, 76.1 years; SD, 8.5 years; range, 65 to 94 years) regarding 4 primary areas related to swallowing disorders: Lifetime and current prevalence, symptoms and signs, risk and protective factors, and socioemotional consequences. Results: The lifetime prevalence of a swallowing disorder was 38%, and 33% of the participants reported a current problem. Most seniors with dysphagia described a sudden onset with chronic problems that had persisted for at least 4 weeks. Stepwise logistic regression identified 3 primary symptoms uniquely associated with a history of swallowing disorders: Taking a longer time to eat (odds ratio [OR], 9.5; 95% confidence interval [CI], 2.3 to 40.2); coughing, throat clearing, or choking before, during, or after eating (OR, 3.4; 95% CI, 1.1 to 10.2); and a sensation of food stuck in the throat (OR, 5.2; 95% CI, 1.8 to 10.0). Stroke (p = .02), esophageal reflux (p = .003), chronic obstructive pulmonary disease (p = .05), and chronic pain (p = .03) were medical conditions associated with a history of dysphagia. Furthermore, dysphagia produced numerous adverse socioemotional effects. Conclusions: This study provides preliminary evidence to suggest that chronic swallowing disorders are common among the elderly, and highlights the need for larger epidemiological studies of these disorders.