Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
권호 표지
DOI QR코드

DOI QR Code

Oropharyngeal Dysphagia in a Community-Based Elderly Cohort: the Korean Longitudinal Study on Health and Aging

  • Yang, Eun Joo (Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Mi Hyun (Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Lim, Jae-Young (Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Paik, Nam-Jong (Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
  • Received : 2013.06.05
  • Accepted : 2013.08.20
  • Published : 2013.10.10
⟨ Previous Next ⟩

Abstract

This study was conducted to investigate the prevalence of dysphagia and evaluated the association of dysphagia and activities of daily living in a geriatric population residing in an independent-living facility in Korea. Korean men and women 65-yr and older living in a single, typical South Korean city (n=415) were enrolled in the Korean Longitudinal Study on Health and Aging study. Dysphagia was assessed using the Standardized Swallowing Assessment. Data were collected on activities of daily living (ADL), instrumental ADL (IADL), and medical history and laboratory. The overall prevalence of dysphagia in the random sample was 33.7% (95% CI, 29.1-38.4), including 39.5% in men and 28.4% in women. The identified risk factors for dysphagia were men (OR, 3.6, P=0.023), history of stroke (OR, 2.7, P=0.042) and presence of major depressive disorder (OR, 3.0, P=0.022). Dysphagia was associated with impairment in IADL domains of preparing meals and taking medicine (P=0.013 and P=0.007, respectively). This is the first published report of the prevalence of dysphagia in older community-dwelling Koreans. Dysphagia is a common problem among elderly people that limits some IADL domains.

Keywords

References

  1. Rofes L, Arreola V, Almirall J, Cabre M, Campins L, Garcia-Peris P, Speyer R, Clave P. Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Pract 2011; 2011. pii: 818979.
  2. Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia 2002; 17: 139-46. https://doi.org/10.1007/s00455-001-0113-5
  3. Rofes L, Arreola V, Romea M, Palomera E, Almirall J, Cabre M, Serra-Prat M, Clave P. Pathophysiology of oropharyngeal dysphagia in the frail elderly. Neurogastroenterol Motil 2010; 22: 851-8.e230. https://doi.org/10.1111/j.1365-2982.2010.01521.x
  4. Robbins J, Langmore S, Hind JA, Erlichman M. Dysphagia research in the 21st century and beyond: proceedings from Dysphagia Experts Meeting, August 21, 2001. J Rehabil Res Dev 2002; 39: 543-8.
  5. Steele CM, Van Lieshout P. Tongue movements during water swallowing in healthy young and older adults. J Speech Lang Hear Res 2009; 52: 1255-67. https://doi.org/10.1044/1092-4388(2009/08-0131)
  6. Steele CM, Van Lieshout PH. The dynamics of lingual-mandibular coordination during liquid swallowing. Dysphagia 2008; 23: 33-46. https://doi.org/10.1007/s00455-007-9093-4
  7. Bennett JW, van Lieshout PH, Steele CM. Tongue control for speech and swallowing in healthy younger and older subjects. Int J Orofacial Myology 2007; 33: 5-18.
  8. Ono T, Hori K, Nokubi T. Pattern of tongue pressure on hard palate during swallowing. Dysphagia 2004; 19: 259-64. https://doi.org/10.1007/s00455-004-0010-9
  9. Achem SR, Devault KR. Dysphagia in aging. J Clin Gastroenterol 2005; 39: 357-71. https://doi.org/10.1097/01.mcg.0000159272.88974.54
  10. Cook IJ. Diagnostic evaluation of dysphagia. Nat Clin Pract Gastroenterol Hepatol 2008; 5: 393-403.
  11. Perry L. Screening swallowing function of patients with acute stroke: part two: detailed evaluation of the tool used by nurses. J Clin Nurs 2001; 10: 474-81. https://doi.org/10.1046/j.1365-2702.2001.00502.x
  12. Osawa A, Maeshima S, Tanahashi N. Water-swallowing test: screening for aspiration in stroke patients. Cerebrovasc Dis 2013; 35: 276-81. https://doi.org/10.1159/000348683
  13. DePippo KL, Holas MA, Reding MJ. Validation of the 3-oz water swallow test for aspiration following stroke. Arch Neurol 1992; 49: 1259-61. https://doi.org/10.1001/archneur.1992.00530360057018
  14. Park JH, Lim S, Lim JY, Kim KI, Han MK, Yoon IY, Kim JM, Chang CB, Chin HJ, Choi EA, et al. An overview of the Korean Longitudinal Study on Health and Aging. Psychiatry Investig 2007; 4: 84-95.
  15. Smithard DG, O'Neill PA, Parks C, Morris J. Complications and outcome after acute stroke: does dysphagia matter? Stroke 1996; 27: 1200-4. https://doi.org/10.1161/01.STR.27.7.1200
  16. Smithard DG, O'Neill PA, England RE, Park CL, Wyatt R, Martin DF, Morris J. The natural history of dysphagia following a stroke. Dysphagia 1997; 12: 188-93. https://doi.org/10.1007/PL00009535
  17. Smithard DG, O'Neill PA, Park C, England R, Renwick DS, Wyatt R, Morris J, Martin DF; North West Dysphagia Group. Can bedside assessment reliably exclude aspiration following acute stroke? Age Ageing 1998; 27: 99-106. https://doi.org/10.1093/ageing/27.2.99
  18. Perry L. Screening swallowing function of patients with acute stroke: part one: identification, implementation and initial evaluation of a screening tool for use by nurses. J Clin Nurs 2001; 10: 463-73. https://doi.org/10.1046/j.1365-2702.2001.00501.x
  19. Won CW, Rho YG, Sun WD, Lee YS. The validity and reliability of Korean Instrumental Activities of Daily Living (KIADL) Scale. J Korean Geriatr Soc 2002; 6: 273-80.
  20. Drouin JM, Valovich-mcLeod TC, Shultz SJ, Gansneder BM, Perrin DH. Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J Appl Physiol 2004; 91: 22-9. https://doi.org/10.1007/s00421-003-0933-0
  21. Nicosia MA, Hind JA, Roecker EB, Carnes M, Doyle J, Dengel GA, Robbins J. Age effects on the temporal evolution of isometric and swallowing pressure. J Gerontol A Biol Sci Med Sci 2000; 55: M634-40. https://doi.org/10.1093/gerona/55.11.M634
  22. Aviv JE, Martin JH, Jones ME, Wee TA, Diamond B, Keen MS, Blitzer A. Age-related changes in pharyngeal and supraglottic sensation. Ann Otol Rhinol Laryngol 1994; 103: 749-52. https://doi.org/10.1177/000348949410301001
  23. Shaw DW, Cook IJ, Gabb M, Holloway RH, Simula ME, Panagopoulos V, Dent J. Influence of normal aging on oral-pharyngeal and upper esophageal sphincter function during swallowing. Am J Physiol 1995; 268: G389-96. https://doi.org/10.1152/ajpcell.1995.268.2.C389
  24. Clave P, Rofes L, Carrion S, Ortega O, Cabre M, Serra-Prat M, Arreola V. Pathophysiology, relevance and natural history of oropharyngeal dysphagia among older people. Nestle Nutr Inst Workshop Ser 2012; 72: 57-66.
  25. Serra-Prat M, Hinojosa G, Lopez D, Juan M, Fabre E, Voss DS, Calvo M, Marta V, Ribo L, Palomera E, et al. Prevalence of oropharyngeal dysphagia and impaired safety and efficacy of swallow in independently living older persons. J Am Geriatr Soc 2011; 59: 186-7. https://doi.org/10.1111/j.1532-5415.2010.03227.x
  26. Lindgren S, Janzon L. Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population. Dysphagia 1991; 6: 187-92. https://doi.org/10.1007/BF02493524
  27. Okamoto N, Tomioka K, Saeki K, Iwamoto J, Morikawa M, Harano A, Kurumatani N. Relationship between swallowing problems and tooth loss in community-dwelling independent elderly adults: the Fujiwarakyo Study. J Am Geriatr Soc 2012; 60: 849-53. https://doi.org/10.1111/j.1532-5415.2012.03935.x
  28. Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging 2012; 7: 287-98.
  29. Kuhlemeier KV, Yates P, Palmer JB. Intra- and interrater variation in the evaluation of videofluorographic swallowing studies. Dysphagia 1998; 13: 142-7. https://doi.org/10.1007/PL00009564
  30. Ramsey DJ, Smithard DG, Kalra L. Early assessments of dysphagia and aspiration risk in acute stroke patients. Stroke 2003; 34: 1252-7. https://doi.org/10.1161/01.STR.0000066309.06490.B8
  31. Logemann JA, Pauloski BR, Rademaker AW, Colangelo LA, Kahrilas PJ, Smith CH. Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men. J Speech Lang Hear Res 2000; 43: 1264-74. https://doi.org/10.1044/jslhr.4305.1264
  32. Yoshikawa M, Yoshida M, Nagasaki T, Tanimoto K, Tsuga K, Akagawa Y, Komatsu T. Aspects of swallowing in healthy dentate elderly persons older than 80 years. J Gerontol A Biol Sci Med Sci 2005; 60: 506-9. https://doi.org/10.1093/gerona/60.4.506
  33. Nagaya M, Sumi Y. Reaction time in the submental muscles of normal older people. J Am Geriatr Soc 2002; 50: 975-6. https://doi.org/10.1046/j.1532-5415.2002.50235.x
  34. Cabre M, Serra-Prat M, Palomera E, Almirall J, Pallares R, Clave P. Prevalence and prognostic implications of dysphagia in elderly patients with pneumonia. Age Ageing 2010; 39: 39-45. https://doi.org/10.1093/ageing/afp100
  35. Janssen I, Heymsfield SB, Wang ZM, Ross R. Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr. J Appl Physiol 2000; 89: 81-8. https://doi.org/10.1152/jappl.2000.89.1.81
  36. Jeon CH, Kim DJ, Kim SK, Lee HM, Park HJ. Validation in the cross-cultural adaptation of the Korean version of the Oswestry Disability Index. J Korean Med Sci 2006; 21: 1092-7. https://doi.org/10.3346/jkms.2006.21.6.1092
  37. Goodwin JS, Samet JM, Hunt WC. Determinants of survival in older cancer patients. J Natl Cancer Inst 1996; 88: 1031-8. https://doi.org/10.1093/jnci/88.15.1031
  38. Palmer JB, Drennan JC, Baba M. Evaluation and treatment of swallowing impairments. Am Fam Physician 2000; 61: 2453-62.
  39. Chan DK, Hung WT, Wong A, Hu E, Beran RG. Validating a screening questionnaire for parkinsonism in Australia. J Neurol Neurosurg Psychiatry 2000; 69: 117-20. https://doi.org/10.1136/jnnp.69.1.117

Cited by

  1. Dysphagia: current reality and scope of the problem vol.12, pp.5, 2013, https://doi.org/10.1038/nrgastro.2015.49
  2. European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome vol.11, pp.None, 2013, https://doi.org/10.2147/cia.s107750
  3. Diagnosis and Clinical Course of Unexplained Dysphagia vol.40, pp.1, 2013, https://doi.org/10.5535/arm.2016.40.1.95
  4. Oropharyngeal Dysphagia in the Elderly vol.6, pp.2, 2013, https://doi.org/10.34160/jkds.2016.6.2.001
  5. Indicators of Dysphagia in Aged Care Facilities vol.60, pp.9, 2013, https://doi.org/10.1044/2017_jslhr-s-17-0028
  6. 3온스 물 삼킴검사 이후 정상 노년층의 음질 변화: 음향학적 분석 vol.10, pp.2, 2013, https://doi.org/10.13064/ksss.2018.10.2.69
  7. The Swallowing Profile of Healthy Aging Adults: Comparing Noninvasive Swallow Tests to Videofluoroscopic Measures of Safety and Efficiency vol.61, pp.7, 2013, https://doi.org/10.1044/2018_jslhr-s-17-0471
  8. Survey for evaluating perceptions of workers in nursing homes regarding swallowing disorders vol.42, pp.3, 2018, https://doi.org/10.21851/obr.42.03.201809.114
  9. Swallow strength training exercise for elderly: A health maintenance need vol.30, pp.10, 2013, https://doi.org/10.1111/nmo.13382
  10. Swallowing Changes in Community-Dwelling Older Adults vol.33, pp.6, 2013, https://doi.org/10.1007/s00455-018-9911-x
  11. Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults vol.3, pp.4, 2018, https://doi.org/10.3390/geriatrics3040090
  12. An intensive swallowing exercise protocol for improving swallowing physiology in older adults with radiographically confirmed dysphagia vol.14, pp.None, 2013, https://doi.org/10.2147/cia.s194723
  13. Swallowing and ageing vol.22, pp.1, 2013, https://doi.org/10.1080/2050571x.2019.1567898
  14. Volumetric Changes to the Pharynx in Healthy Aging: Consequence for Pharyngeal Swallow Mechanics and Function vol.34, pp.1, 2019, https://doi.org/10.1007/s00455-018-9924-5
  15. The GUSS test as a good indicator to evaluate dysphagia in healthy older people: a multicenter reliability and validity study vol.10, pp.6, 2013, https://doi.org/10.1007/s41999-019-00249-2
  16. Dysphagia and factors associated with malnutrition risk: A 5‐year multicentre study vol.75, pp.12, 2013, https://doi.org/10.1111/jan.14188
  17. Dentistry considerations for the dysphagic patient: Recognition of condition and management vol.28, pp.4, 2019, https://doi.org/10.1177/2010105819868252
  18. Comparative Analysis of Cognitive and Physical Function according to Dysphagia of Aged Patients in Geriatric Hospitals vol.21, pp.3, 2013, https://doi.org/10.17079/jkgn.2019.21.3.190
  19. Simultaneous double balloon dilatation using double channel therapeutic endoscope in patients with cricopharyngeal muscle dysfunction : An observative study vol.99, pp.35, 2020, https://doi.org/10.1097/md.0000000000021793
  20. How to Cope with Big Data in Functional Analysis of the Esophagus vol.36, pp.6, 2013, https://doi.org/10.1159/000511931
  21. Validity Evidence of an Epidemiological Oropharyngeal Dysphagia Screening Questionnaire for Older Adults vol.75, pp.None, 2013, https://doi.org/10.6061/clinics/2020/e1425
  22. Prevalence and characterization of dysphagia in hospitalized patients vol.32, pp.3, 2020, https://doi.org/10.1111/nmo.13763
  23. Development of an Ultrasonic Doppler Sensor-Based Swallowing Monitoring and Assessment System vol.20, pp.16, 2013, https://doi.org/10.3390/s20164529
  24. Factors associated with signs of aspiration in older adults: A prospective study vol.41, pp.5, 2013, https://doi.org/10.1016/j.gerinurse.2020.03.019
  25. Preconditioning human pharyngeal motor cortex enhances directional metaplasticity induced by repetitive transcranial magnetic stimulation vol.598, pp.22, 2013, https://doi.org/10.1113/jp279977
  26. Potential Prognostic Impact of Dopamine Receptor D1 ( rs4532 ) Polymorphism in Post-stroke Outcome in the Elderly vol.12, pp.None, 2013, https://doi.org/10.3389/fneur.2021.675060
  27. Preclinical Dysphagia in Community Dwelling Older Adults: What Should We Look For? vol.30, pp.2, 2021, https://doi.org/10.1044/2020_ajslp-20-00014
  28. Profiles of polypharmacy in older adults and medication associations with signs of aspiration vol.14, pp.5, 2013, https://doi.org/10.1080/17512433.2021.1909474
  29. Depression is Associated with Chewing and Swallowing Function among Elderly Vendors in a Conventional Market: A Preliminary Research vol.11, pp.2, 2013, https://doi.org/10.34160/jkds.2021.11.2.006
  30. The Dysphagia Handicap Index (DHI)-Normative Values. Systematic Review and Meta-Analysis vol.36, pp.6, 2013, https://doi.org/10.1007/s00455-020-10231-x
  31. A systematic review and meta‐analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia vol.49, pp.1, 2013, https://doi.org/10.1111/joor.13274