Post-Stroke Dysphagia in Patients with Ischemic Stroke Aged ≥ 80 Years Treated with Reperfusion Therapies: Experience from a Tertiary Stroke Center in Armenia

Abstract

Background

Post-stroke dysphagia is common but often overlooked, especially in patients aged ≥80 years, significantly impacting functional outcomes and quality of life. Despite advances in reperfusion therapies (RTs) for ischemic stroke, dysphagia remains prevalent among older adults. This study aimed to evaluate clinical characteristics and early functional outcomes of post-stroke dysphagia in older adults treated with RT.

Methods

A cross-sectional, prospective study was conducted at Astghik Medical Center, Armenia, including 52 participants aged ≥80 years who received RT between January and December 2022. Dysphagia was assessed using the Gugging Swallowing Screen (GUSS) within 24 h after RT. Clinical outcomes, including mortality, dysphagia severity, and functional recovery, were evaluated at discharge and 3 months post-stroke using the modified Rankin Scale (mRS) and GUSS scores.

Results

Of the 52 participants, 32 (62%) developed dysphagia. Dysphagia was associated with higher NIHSS scores at admission (p = 0.03). The in-hospital mortality rate for those with dysphagia was 15.6%, with a 3-month mortality rate of 37%. Participants with dysphagia showed poorer functional recovery, with 41% achieving mRS scores of 0–2 at 3 months compared to 90% in the non-dysphagia group (p = 0.03). Two participants required nasogastric feeding, and 56.2% needed dietary modifications at discharge.

Conclusions

Post-stroke dysphagia is prevalent in patients with ischemic stroke aged ≥80 years, affecting both acute and long-term outcomes. Early screening and multidisciplinary management, including swallowing therapy, are essential for improving functional recovery.