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Auris Nasus Larynx. 2020 Feb 19. pii: S0385-8146(20)30035-3. doi: 10.1016/j.anl.2020.02.004. [Epub ahead of print]

Implementing a flexible endoscopic evaluation of swallowing at elderly care facilities to reveal characteristics of elderly subjects who screened positive for a swallowing disorder.

Author information

1
Department of Otolaryngology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan. Electronic address: ima-mitu@fmu.ac.jp.
2
Department of Otolaryngology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.
3
Health Information and Epidemiology Center for Integrated Science and Humanities, Fukushima Medical University, Japan.
4
Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Japan.

Abstract

OBJECTIVES:

The risk of aspiration pneumonia has been reported to increase with age, especially in elderly residents of nursing homes. However, the characteristics of those with swallowing impairments at elderly care facilities have not yet been evaluated using reliable instrumental examinations. The aims of the current study were to investigate the frequency of swallowing impairment and determine the characteristics of the elderly with swallowing disorders residing at care facilities.

METHODS:

To reveal the characteristics of the elderly with swallowing disorders, questionnaires for dysphagia screening and flexible endoscopic evaluation of swallowing (FEES) were used. Regarding the dysphagia screening, two types of questionnaires were sent to 451 elderly persons aged 65 years and older who were living in facilities for the elderly in Japan. FEES was performed to assess swallowing impairment at each facility for those who were found to be positive for dysphagia by the questionnaires. The frequency of swallowing impairment and the characteristics of elderly subjects with swallowing disorders were investigated.

RESULTS:

Among 413 subjects who completed both questionnaires, 229 were screened positive for dysphagia, 160 of whom underwent FEES. Swallowing impairment was observed in 93 subjects. The subjects with swallowing impairment had a significantly high prevalence of fever, sputum, and/or history of aspiration pneumonia. Their oral intake ability and activities of daily living were significantly low.

CONCLUSION:

We demonstrated the frequency of swallowing disorders and the characteristics of elderly subjects with swallowing disorders living in care facilities using FEES. Our results suggest the importance of screening all elderly care facility residents for dysphagia.

KEYWORDS:

Care facilities for the elderly; Flexible endoscopic evaluation of swallowing (FEES); Questionnaire for dysphagia screening; Swallowing disorders

PMID:
32088014
DOI:
10.1016/j.anl.2020.02.004

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