Association of swallowing problems with frailty in Chinese hospitalized older patients.
Tiantian Wang, Yanwei Zhao, Aimin Guo
PMID 33195752WHAT IT FOUND
Among 386 hospitalized older patients, swallowing problems were linked to frailty: 48.9% of frail and 32.4% of pre-frail had swallowing problems, versus 13.6% of non-frail.
Key findings
01In 386 hospitalized older patients, 31.1% had swallowing problems on the water swallow test, rising to 52.9% among those aged 80 years or older.
02Swallowing problems were more frequent with frailty: 48.9% of frail participants, 32.4% of pre-frail participants, and 13.6% of non-frail participants had dysphagia.
03In adjusted logistic regression, frailty and a history of choking or coughing while drinking were associated with dysphagia, with odds ratios of 5.420 for frail, 2.906 for pre-frail, and 2.954 for choking or coughing history.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Cross-sectional design at one hospital with convenience sampling, so it shows association, not cause, and may not apply to other settings. Patients with common causes of swallowing problems, such as stroke, Parkinson's disease, dementia, head and neck cancer, neuromuscular disease, or known swallowing dysfunction, were excluded. The water swallow test had 20.0% specificity compared with video fluoroscopy, so it can produce false positives and may miss silent aspiration. The test assessed only pharyngeal swallowing and did not assess chewing. Participants had higher activities of daily living scores than other studies, so selection bias may exist.
Declared interests
All authors declared that there were no actual or potential conflicts of interest.
The easy way to misread this
Do not treat the water swallow test as a definitive diagnosis or frailty as proof of cause. The study was cross-sectional, and the test had 20.0% specificity compared with video fluoroscopy, so false positives and missed silent aspiration are possible.