To investigate whether dysphagia symptoms are associated with the incidence of physical pre-frailty and frailty in older adults.
Methods
A sample of 149 participants without pre-frailty or frailty at baseline was analyzed. Data were collected at baseline and at a 9-year follow-up. A multinomial regression model was run and controlled for socioeconomic, behavioral, and clinical characteristics.
Results
Many participants (41.6%) had dysphagia symptoms. Dysphagia symptoms were associated with physical pre-frailty (RR = 2.37, 95%CI 1.02–5.50) and frailty (RR = 3.64, 95%CI 1.01–13.21).
Conclusion
Dysphagia symptoms are associated with an increased likelihood of incident physical pre-frailty and frailty in community-dwelling older adults. Thus, early multidisciplinary identification of dysphagia symptoms in older adults can help prevent pre-frailty and frailty in this population.
AssumpçãoD. D.FranciscoP. M. S. B.BorimF. S. A.YassudaM. S.NeriA. L. (2021). Which anthropometric measures best identify excess weight in older adults?Geriatrics Gerontology and Aging, 15, e0210051. https://doi.org/10.53886/gga.e0210051
2.
BaijensL. W.ClavéP.CrasP.EkbergO.ForsterA.KolbG. F.LenersJ.-C.MasieroS.Mateos-NozalJ.OrtegaO.SmithardD. G.SpeyerR.WalsheM. (2016). European society for swallowing disorders - European union geriatric medicine society white paper: Oropharyngeal dysphagia as a geriatric syndrome. Clinical Interventions in Aging, 11, 1403–1428. https://doi.org/10.2147/CIA.S107750
3.
BelafskyP. C.MouadebD. A.ReesC. J.PryorJ. C.PostmaG. N.AllenJ.LeonardR. J. (2008). Validity and reliability of the eating assessment tool (EAT-10). Annals of Otology, Rhinology & Laryngology, 117(12), 919–924. https://doi.org/10.1177/08845336093320054
4.
BruckiS. M. D.NitriniR.CaramelliP.BertolucciP. H. F.OkamotoI. H. (2003). Sugestões para o uso do mini-exame do estado mental no Brasil. Arquivos de Neuro-Psiquiatria, 61(3B), 777–781. https://doi.org/10.1590/S0004-282X2003000500014
5.
DaggettA.LogemannJ.RademakerA.PauloskiB. (2006). Laryngeal penetration during deglutition in normal subjects of various ages. Dysphagia, 21(4), 270–274. https://doi.org/10.1007/s00455-006-9051-6
6.
DentE.MorleyJ. E.Cruz-JentoftA. J.WoodhouseL.Rodríguez-MañasL.FriedL. P.WooJ.AprahamianI.SanfordA.LundyJ.LandiF.BeilbyJ.MartinF. C.BauerJ. M.FerrucciL.MerchantR. A.DongB.AraiH.HoogendijkE. O.VellasB. (2019). Physical frailty: ICFSR international clinical practice guidelines for identification and management. The Journal of Nutrition, Health & Aging, 23(9), 771–787. https://doi.org/10.1007/s12603-019-1273-z
7.
FengZ.LugtenbergM.FranseC.FangX.HuS.JinC.RaatH. (2017). Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies. PLOS ONE, 12(6), Article e0178383. https://doi.org/10.1371/journal.pone.0178383
8.
FolsteinM. F.FolsteinS. E.McHughP. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. https://doi.org/10.1016/0022-3956(75)90026-6
9.
FriedL. P.TangenC. M.WalstonJ.NewmanA. B.HirschC.GottdienerJ.SeemanT.TracyR.KopW. J.BurkeG.McBurnieM. A.Cardiovascular Health Study Collaborative Research Group. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology: Series A, Biological Sciences and Medical Sciences, 56(3), M146–M156. https://doi.org/10.1093/gerona/56.3.M146
10.
GonçalvesM. I.RemailiC. B.BehlauM. (2013). Cross-cultural adaptation of the Brazilian version of the eating assessment tool—EAT-10. CoDAS, 25(6), 601–604. https://doi.org/10.1590/s2317-17822013.05000012
11.
HollandG.JayasekeranV.PendletonN.HoranM.JonesM.HamdyS. (2011). Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: A self-reporting questionnaire survey. Diseases of the Esophagus, 24(7), 476–480. https://doi.org/10.1111/j.1442-2050.2011.01182.x
12.
HoribeY.UedaT.WatanabeY.MotokawaK.EdahiroA.HiranoH.ShirobeM.OgamiK.KawaiH.ObuchiS.KimH.SakuraiK. (2018). A 2-year longitudinal study of the relationship between masticatory function and progression to frailty or pre-frailty among community-dwelling Japanese aged 65 and older. Journal of Oral Rehabilitation, 45(11), 864–870. https://doi.org/10.1111/joor.12700
13.
IwasakiM.YoshiharaA.SatoN.SatoM.MinagawaK.ShimadaM.NishimutaM.AnsaiT.YoshitakeY.OnoT.MiyazakiH. (2018). A 5-year longitudinal study of association of maximum bite force with development of frailty in community-dwelling older adults. Journal of Oral Rehabilitation, 45(1), 17–24. https://doi.org/10.1111/joor.12578
14.
LewinsohnP. M.SeeleyJ. R.RobertsR. E.AllenN. B. (1997). Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychology and Aging, 12(2), 277–287. https://doi.org/10.1037/0882-7974.12.2.277
15.
LogemannJ. A. (1998). Evaluation and treatment of swallowing disorders (2nd ed.). Pro-Ed.
16.
LustosaL. P.PereiraD. S.DiasR. C.BrittoR. R.ParentoniA. N.PereiraL. S. M. (2011). Translation and cultural adaptation of the Minnesota Leisure Time Activities Questionnaire in community-dwelling older people. Geriatrics, Gerontology and Aging, 5(2), 57–65.
17.
MadhavanA.LaGorioL. A.CraryM. A.DahlW. J.CarnabyG. D. (2016). Prevalence of and risk factors for dysphagia in the community dwelling elderly: A systematic review. The Journal of Nutrition, Health & Aging, 20(8), 806–815. https://doi.org/10.1007/s12603-016-0712-3
18.
MannT.HeubergerR.WongH. (2013). The association between chewing and swallowing difficulties and nutritional status in older adults. Australian Dental Journal, 58(2), 200–206. https://doi.org/10.1111/adj.12064
19.
MelloR. P.XavierM. O.TomasiE.GonzalezM. C.DemarcoF. F.BielemannR. M. (2022). Dysphagia perception among community-dwelling older adults from a municipality in southern Brazil. Dysphagia, 37(4), 879–888. https://doi.org/10.1007/s00455-021-10347-8
20.
MolfenterS. M. (2022). The relationship between sarcopenia, dysphagia, malnutrition, and frailty: Making the case for proactive swallowing exercises to promote healthy aging. Current Opinion in Otolaryngology & Head and Neck Surgery, 30(6), 400–405. https://doi.org/10.1097/MOO.0000000000000835
21.
MolfenterS. M.BratesD.HerzbergE.NooraniM.LazarusC. (2018). The swallowing profile of healthy aging adults: Comparing noninvasive swallow tests to videofluoroscopic measures of safety and efficiency. Journal of Speech, Language, and Hearing Research: JSLHR, 61(7), 1603–1612. https://doi.org/10.1044/2018_JSLHR-S-17-0471
22.
MorleyJ. E.VellasB.van KanG. A.AnkerS. D.BauerJ. M.BernabeiR.CesariM.ChumleaW. C.DoehnerW.EvansJ.FriedL. P.GuralnikJ. M.KatzP. R.MalmstromT. K.McCarterR. J.Gutierrez RobledoL. M.RockwoodK.von HaehlingS.VandewoudeM. F.WalstonJ. (2013). Frailty consensus: A call to action. Journal of the American Medical Directors Association, 14(6), 392–397. https://doi.org/10.1016/j.jamda.2013.03.022
23.
MourãoL. F.XavierD. A. N.NeriA. L.LuchesiK. F. (2016). Association study between natural chronic diseases of aging and swallowing changes referred by community elderly. Audiology - Communication Research, 21, e1657. https://doi.org/10.1590/2317-6431-2015-1657
24.
NeriA. L.MeloR. C. D.BorimF. S. A.AssumpçãoD. D.CipolliG. C.YassudaM. S. (2022). Follow-up evaluation of the fibra study: Sociodemographic, cognitive, and frailty characterization of older adults in Campinas and Ermelino Matarazzo, SP. Revista Brasileira de Geriatria e Gerontologia, 25(5), Article e210224. https://doi.org/10.1590/1981-22562022025.210224
25.
NeriA. L.YassudaM. S.de AraújoL. F.EulálioM. do C.CabralB. E.de SiqueiraM. E. C.dos SantosG. A.de Arruda MouraJ. G. (2013). Metodologia e perfil sociodemográfico, cognitivo e de fragilidade de idosos comunitários de sete cidades brasileiras: Estudo FIBRA. Cadernos de Saúde Pública, 29(4), 778–792. https://doi.org/10.1590/S0102-311X2013000400015
26.
NeyD. M.WeissJ. M.KindA. J. H.RobbinsJ. (2009). Senescent swallowing: Impact, strategies, and interventions. Nutrition in Clinical Practice, 24(3), 395–413. https://doi.org/10.1177/0884533609332005
27.
Ofori-AsensoR.ChinK. L.MazidiM.ZomerE.IlomäkiJ.ZulloA. R.GasevicD.AdemiZ.KorhonenM. J.LoGiudiceD.BellJ. S.LiewD. (2019). Global incidence of frailty and prefrailty among community-dwelling older adults. JAMA Network Open, 2(8), Article e198398. https://doi.org/10.1001/jamanetworkopen.2019.8398
28.
OrtegaO.CabréM.ClavéP. (2014). Oropharyngeal dysphagia: Aetiology and effects of ageing. Journal of Gastroenterology and Hepatology Research, 3(5), 1049–1054. https://doi.org/10.6051/jghr.v3i5.693
29.
RechR. S.de GoulartB. N. G.dos SantosK. W.MarcolinoM. A. Z.HilgertJ. B. (2022). Frequency and associated factors for swallowing impairment in community-dwelling older persons: A systematic review and meta-analysis. Aging Clinical and Experimental Research, 34(12), 2945–2961. https://doi.org/10.1007/s40520-022-02258-x
30.
SakaiK.NakayamaE.YoneokaD.SakataN.IijimaK.TanakaT.HayashiK.SakumaK.HoshinoE. (2022). Association of oral function and dysphagia with frailty and sarcopenia in community-dwelling older adults: A systematic review and meta-analysis. Cells, 11(14), 2199. https://doi.org/10.3390/cells11142199
31.
SembaR. D.BlaumC. S.BartaliB.XueQ. L.RicksM. O.GuralnikJ. M.FriedL. P. (2006). Denture use, malnutrition, frailty, and mortality among older women living in the community. The Journal of Nutrition, Health & Aging, 10(2), 161–167.
32.
ShimazakiY.NonoyamaT.TsushitaK.AraiH.MatsushitaK.UchiboriN. (2020). Oral hypofunction and its association with frailty in community-dwelling older people. Geriatrics & Gerontology International, 20(10), 917–926. https://doi.org/10.1111/ggi.14015
33.
TakeuchiN.SawadaN.EkuniD.MoritaM. (2022). Oral factors as predictors of frailty in community-dwelling older people: A prospective cohort study. International Journal of Environmental Research and Public Health, 19(3), 1145. https://doi.org/10.3390/ijerph19031145
34.
TanakaT.TakahashiK.HiranoH.KikutaniT.WatanabeY.OharaY.FuruyaH.TetsuoT.AkishitaM.IijimaK. (2018). Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 73(12), 1661–1667. https://doi.org/10.1093/gerona/glx225
35.
YamanashiH.ShimizuY.HigashiM.KoyamatsuJ.SatoS.NagayoshiM.KadotaK.KawashiriS.TamaiM.TakamuraN.MaedaT. (2018). Validity of maximum isometric tongue pressure as a screening test for physical frailty: Cross-sectional study of Japanese community-dwelling older adults. Geriatrics & Gerontology International, 18(2), 240–249. https://doi.org/10.1111/ggi.13166
36.
YangR. Y.YangA. Y.ChenY. C.LeeS. D.LeeS. H.ChenJ. W. (2022). Association between dysphagia and frailty in older adults: A systematic review and meta-analysis. Nutrients, 14(9), 1812. https://doi.org/10.3390/nu14091812
37.
YannakouliaM.NtanasiE.AnastasiouC. A.ScarmeasN. (2017). Frailty and nutrition: From epidemiological and clinical evidence to potential mechanisms. Metabolism: Clinical and Experimental, 68, 64–76. https://doi.org/10.1016/j.metabol.2016.12.005
