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Factors Associated with Self-Reported Dysphagia in Older Adults Receiving Meal Support

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Dysphagia is common in older adults. However, there are no current estimates of dysphagia in community-dwelling older adults those receiving meal support. It is unknown whether dysphagia is associated with other measures of physical function (activities of daily living [ADL] ability or nutrition status). The study purposes were to determine the prevalence of self-reported dysphagia and to identify factors associated with self-reported dysphagia in community-dwelling older adults receiving meal support.

Design

A cross-sectional study.

Setting and Participants

476 community-dwelling older adults (78.5±0.51 years) across five Elder Nutrition Program meal services in Wisconsin participated in the study.

Measurements

Data were collected through administration of validated ADL and nutrition questionnaires (nutritional status, functional status with ADLs, chewing ability, dental conditions, and prior diagnoses of dysphagia, pneumonia, and dementia). For self-reported dysphagia, the validated 10-item eating assessment tool (EAT-10) was used.

Results

The prevalence of self-reported dysphagia (EAT-10 score of ≥ 3) was 20.4%. Multivariate logistic regression results indicated that poor nutritional status (OR=3.1, p=0.04), difficulty chewing (OR=2.2, p=0.03), prior dysphagia diagnosis (OR=34.8, p<0.001), prior pneumonia diagnosis (OR=2.1, p=0.04), and meal service site (OR=2.68, p=0.02) were associated with self-reported dysphagia.

Conclusion

Approximately one in five community-dwelling older adults receiving meal support had self-reported dysphagia. Increased risk for poor nutrition, reduced chewing ability, prior dysphagia and pneumonia diagnosis, and meal service site were identified as factors associated with dysphagia on the EAT-10. Results highlight the need for further studies across more sites to identify dysphagia risk indicators in community-dwelling older adults receiving meal support state-wide.

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Abbreviations

ADL:

activities of daily living

BMI:

body mass index

CI:

confidence interval

EAT-10:

Eating Assessment Tool

ENP:

Elder Nutrition Program

IADL:

Instrumental Activities of Daily Living

OAA:

Older Americans Act

OR:

Odds Ratio

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Acknowledgements

Financial Disclosure: This work was supported by National Institutes of Health (NIH) Grants 1K23AG057805-01A1 (awarded to N.R.P.) and T32DC009401 (supporting A.K.). Additionally, the study was supported by the Community-Academic Aging Research Network (CAARN) through funding from NIH Grant 1RC4AG038175-01, the UW-Madison School of Medicine and Public Health, the UW-Madison Office of the Vice Chancellor for Research and Graduate Education, and the UW-Madison Institute for Clinical and Translational Research through funding from NIH CTSA grant 1UL1TR002373 and UW-Madison SMPH Wisconsin Partnership Program grant 3086. The article was partially prepared at the William S. Middleton Veteran Affairs Hospital in Madison, WI; GRECC manuscript 002-2022.

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Authors and Affiliations

  1. Division of Otolaryngology- Head & Neck Surgery, Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA

    A. Kurosu, M. Ciucci & Nicole Rogus-Pulia

  2. Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA

    F. Osman & S. Daggett

  3. Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA

    R. Peña-Chávez, M. Ciucci & Nicole Rogus-Pulia

  4. Dpto. de Ciencias de la Rehabilitación en Salud, Universidad del Bío-Bío, Concepción, Chile

    R. Peña-Chávez

  5. Fresh Meals On Wheels of Sheboygan County, Inc., Madison, WI, USA

    A. Thompson

  6. Bureau of Aging and Disability Resources, Department of Medicine and Public Health-CAARN, University of Wisconsin-Madison, Madison, WI, USA

    S. M. Myers

  7. Greater WI Agency on Aging Resources, Inc, Madison, WI, USA

    P. VanKampen

  8. Wisconsin Department of Health Services, Madison, WI, USA

    S. S. Koenig

  9. Division of Geriatrics, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA

    J. Mahoney & Nicole Rogus-Pulia

  10. Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA

    Nicole Rogus-Pulia

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Contributions

Author contributions: A.K. contributed substantially to the study design, data analysis, data interpretation, and drafting and revising the article and approved the final submitted version. F.O. contributed substantially to data abstraction, data analysis, data interpretation, revising the article, and approved the final submitted version. S.D. contributed substantially to the study design, data abstraction, data acquisition, and revising the article, and approved the final submitted version. A.T., S.M.M., P.V., and S.K. contributed substantially to the data acquisition, revising the article and approved the final submitted version. R.P.C. and M.C.contributed to revising the article and approved the final submitted version. J.M. and N.R.P. contributed substantially to the study design, data acquisition and interpretation, and revising the article and approved the final submitted version.

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Correspondence to Nicole Rogus-Pulia.

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Sponsor’s Role: The views and content expressed in this article are solely the responsibility of the authors and do not necessarily reflect the position, policy, or official views of the Department of Veteran Affairs, the U.S. government, or the NIH.

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Kurosu, A., Osman, F., Daggett, S. et al. Factors Associated with Self-Reported Dysphagia in Older Adults Receiving Meal Support. J Nutr Health Aging 25, 1145–1153 (2021). https://doi.org/10.1007/s12603-021-1700-9

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