, Volume 24, Issue 1, pp 1–6 | Cite as

Prevalence of Perceived Dysphagia and Quality-of-Life Impairment in a Geriatric Population

  • Po-Hung Chen
  • Justin S. Golub
  • Edie R. Hapner
  • Michael M. JohnsIIIEmail author
Original Article


Dysphagia is an important problem for the elderly. While well characterized in acutely ill populations, the prevalence and quality-of-life changes associated with dysphagia remain poorly defined in the community geriatric population. This study recruited individuals 65 years and older from an independent-living facility. Two validated questionnaires were used: the M.D. Anderson Dysphagia Inventory (MDADI) and the general health Short Form-12 survey (SF-12v2TM). Each participant also answered two questions: “Do you have difficulties with swallowing?” and “Do you think that swallowing difficulties are a natural part of aging?” Fifteen percent of subjects reported difficulties with swallowing. Of these, over half suffered substantial quality-of-life impairment in one or more domains of the MDADI. With respect to the second question, 23.4% of subjects believed dysphagia to be a normal part of aging, 37.4% did not. The SF-12v2 only weakly correlated with the MDADI in this population. In conclusion, there is a relatively high prevalence of dysphagia in the community-based geriatric population; significant quality-of-life impairment is a frequent finding. General health measures do not appear to be sensitive to swallowing-related quality of life. Finally, individuals may inaccurately ascribe swallowing problems to normal aging, supporting the role of community education about dysphagia in the elderly.


Dysphagia Swallowing Esophagus Pharynx Geriatric Aging Deglutition Deglutition disorders 


  1. 1.
    US Census Bureau, U.S. interim projections by age, sex, race, and Hispanic origin 2004. Available at Accessed 1 March 2007.
  2. 2.
    Schindler JS, Kelly JH. Swallowing disorders in the elderly. Laryngoscope 2002;112(4):589–602.PubMedCrossRefGoogle Scholar
  3. 3.
    Palmer JB, Drennan JC, Baba M. Evaluation and treatment of swallowing impairments. Am Fam Physician 2000;61(8):2453–62.PubMedGoogle Scholar
  4. 4.
    Wilkins T, Gillies RA, Thomas AM, Wagner PJ. The prevalence of dysphagia in primary care patients: a HamesNet Research Network study. J Am Board Fam Med 2007;20(2):144–50.PubMedCrossRefGoogle Scholar
  5. 5.
    Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke 2005;36(12):2756–63.PubMedCrossRefGoogle Scholar
  6. 6.
    Nguyen NP, Sallah S, Karlsson U, Antoine JE. Combined chemotherapy and radiation therapy for head and neck malignancies: quality of life issues. Cancer 2002;94(4):1131–41.PubMedCrossRefGoogle Scholar
  7. 7.
    Siebens H, Trupe E, Siebens A, Cook F, Anshen S, Hanauer R, et al. Correlates and consequences of eating dependency in institutionalized elderly. J Am Geriatr Soc 1986;34(3):192–8.PubMedGoogle Scholar
  8. 8.
    Lin LC, Wu SC, Chen HS, Wang TG, Chen MY. Prevalence of impaired swallowing in institutionalized older people in Taiwan. J Am Geriatr Soc 2002;50(6):1118–23.PubMedCrossRefGoogle Scholar
  9. 9.
    Roy N, Stemple J, Merrill RM, Thomas L. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Ann Otol Rhinol Laryngol 2007;116(11):858–65.PubMedGoogle Scholar
  10. 10.
    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(4):187–92.PubMedCrossRefGoogle Scholar
  11. 11.
    Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest 2004;125(2):801–2.CrossRefGoogle Scholar
  12. 12.
    Tibbling L, Gustafsson B. Dysphagia and its consequences in the elderly. Dysphagia 1991;6(4):200–2.PubMedCrossRefGoogle Scholar
  13. 13.
    Duthie EH, Katz PR. Practice of geriatrics. 3rd edn. Philadelphia PA: W.B. Saunders; 1998.Google Scholar
  14. 14.
    Chen AY, Frankowski R, Bishop-Leone J, Hebert T, Leyk S, Lewin J, et al. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M.D. Anderson Dysphagia Inventory. Arch Otolaryngol Head Neck Surg 2001;127:870–6.PubMedGoogle Scholar
  15. 15.
    Ware JE, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996;34(3):220–33.PubMedCrossRefGoogle Scholar
  16. 16.
    Ware JE, Turner-Bowker DM, Kosinski 0M, Gandek B. SF-12v2™: How to score version 2 of the SF-12® Health Survey. Lincoln, RI: QualityMetric Incorporated; 2002.Google Scholar
  17. 17.
    Nicosia MA, Hind JA, Roecker EB, Carnes M, Doyle J, Dengel GA, et al. Age effects on the temporal evolution of isometric and swallowing pressure. J Gerontol A Biol Sci Med Sci 2000;55(11):M634–40.PubMedGoogle Scholar
  18. 18.
    Aviv JE, Martin JH, Jones ME, Wee TA, Diamond B, Keen MS, et al. Age-related changes in pharyngeal and supraglottic sensation. Ann Otol Rhinol Laryngol 1994;103(10):749–52.PubMedGoogle Scholar
  19. 19.
    Shaw DW, Cook IJ, Gabb M, Holloway RH, Simula ME, Panagopoulos V, et al. Influence of normal aging on oral-pharyngeal and upper esophageal sphincter function during swallowing. Am J Physiol 1995;268(3 Pt 1):G389–96.PubMedGoogle Scholar
  20. 20.
    McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, et al. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia 2002;17(2):97–114.PubMedCrossRefGoogle Scholar
  21. 21.
    Golub JS, Chen PH, Otto KJ, Hapner E, Johns MM 3rd. Prevalence of perceived dysphonia in a geriatric population. J Am Geriatr Soc 2006;54(11):1736–39.PubMedCrossRefGoogle Scholar
  22. 22.
    Johns MM, Garrett CG, Hwang J, Ossoff RH, Courey MS. Quality-of-life outcomes following laryngeal endoscopic surgery for non-neoplastic vocal fold lesions. Ann Otol Rhinol Laryngol 2004;113(8):597–601.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Po-Hung Chen
    • 1
  • Justin S. Golub
    • 1
  • Edie R. Hapner
    • 2
  • Michael M. JohnsIII
    • 2
    • 3
    Email author
  1. 1.Emory University School of MedicineAtlantaUSA
  2. 2.Department of Otolaryngology-Head and Neck Surgery, Emory Voice CenterEmory University School of MedicineAtlantaUSA
  3. 3.The Emory Voice CenterAtlantaUSA

Personalised recommendations