Geriatric dysphagia and pneumonia

Abstract

Research Objective: To investigate predictors of pneumonia and subsequent hospitalisation in older adults with dysphagia. Methods: Adults aged 60 and over living in the community and in nursing facilities who exhibit signs of dysphagia. The 3-oz water swallowing test was used to determine presence of dysphagia. Review of medical history examined for major chronic conditions, pneumonia diagnoses and hospitalization, dependence for activities of daily living (ADL), and number of medications taken at the time of assessment. Logistic regression was used to identify associations between various factors and pneumonia. Descriptive statistics were used to compare pneumonia cases with and without subsequent hospitalization. Results: Based on the 3-oz water swallowing test, 98 were deemed dysphagic. Their mean age was 83.5 years (SD=7.1), with 52 females. 86 needed some level of assistance with ADL; 64 needed help during mealtimes, 89 were not independently mobile. Univariate logistic regression revealed that male gender and neurological disease were highly predictive of pneumonia in elderly with dysphagia. Among the diagnosis of neurological disease, dementia seems the most likely predictor, however the promising odds ratio with a non-significant p-value suggests a larger sample size is needed, one of the limitations of the study. Comparison of descriptive statistics between the 3 groups supports the initial findings, as well as factors that did not emerge in regression due to the small sample size. Conclusions: Initial profiles are established for those with pneumonia, with and without hospitalisation, in older adults. These profiles can guide clinicians in flagging dysphagic patients who may be at risk for adverse outcomes, and provide adequate additional care.