Identifying Dysphagia and Demographic Associations in Older Adults Using Electronic Health Records: A National Longitudinal Observational Study in Wales (United Kingdom) 2008-2018.
Joe Hollinghurst, David G Smithard
PMID 35212847WHAT IT FOUND
Health records of older adults in Wales recorded swallowing difficulty more often in people who were older, frail, or living in more deprived areas.
Key findings
01Dysphagia was recorded in the year before cohort entry for 0.6% to 0.8% of people aged 65+.
02Compared with fit people, the model reported increased odds ratios for recorded dysphagia of 2.45 for mild frailty, 4.63 for moderate frailty, and 7.87 for severe frailty.
03The model reported increased odds ratios for recorded dysphagia of 1.09 for ages 75-84 and 1.23 for ages 85+ compared with ages 65-74, and 1.10 for most deprived compared with least deprived.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The outcome was a recorded dysphagia or swallowing problem in health records, not a confirmed clinical swallowing assessment, so it shows recording rather than true prevalence. Coding may be incomplete, inaccurate, or inconsistent, and some codes may not directly relate to oropharyngeal dysphagia. Not all general practices contributed to the databank, and some individuals were lost during record matching, so coverage was not complete. The design is observational and cross-sectional by annual cohort, so it cannot show that age, frailty, or deprivation caused dysphagia. Health professionals may not routinely ask or screen for swallowing, so people with swallowing difficulty may be missing from the records.
Declared interests
The study was funded by the Medical Research Council, Health and Care Research Wales, Health Data Research UK, and the Economic and Social Research Council. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read the 0.6% to 0.8% previous-year recording rate as the true prevalence of dysphagia in older adults. The study counted only swallowing problems already coded in health records, and the authors note that swallowing may be under-reported, under-screened, and coded inconsistently.